Considerable Variability in the Efficacy of 8% Capsaicin Topical Patches in the Treatment of Chronic Pruritus in 3 Patients with Notalgia Paresthetica

Botulinum toxin is a superfamily of neurotoxins produced by the bacterium Clostridium Botulinum with well-established efficacy and safety profile in focal idiopathic hyperhidrosis. Recently, botulinum toxins have also been used in many other skin diseases, in off label regimen. The objective of this manuscript is to review and analyze the main therapeutic applications of botulinum toxins in skin diseases. A systematic review of the published data was conducted, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Botulinum toxins present several label and off-label indications of interest for dermatologists. The best-reported evidence concerns focal idiopathic hyperhidrosis, Raynaud phenomenon, suppurative hidradenitis, Hailey–Hailey disease, epidermolysis bullosa simplex Weber–Cockayne type, Darier’s disease, pachyonychia congenita, aquagenic keratoderma, alopecia, psoriasis, notalgia paresthetica, facial erythema and flushing, and oily skin. Further clinical trials are still needed to better understand the real efficacy and safety of these applications and to standardize injection and doses protocols for off label applications.

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What are important predictors of perceived stigmatization in patients with psoriasis? Commentary to ‘Significance of chronic pruritus for intrapersonal burden and interpersonal experiences of stigmatization and sexuality in patients with psoriasis’ by R. Sommer et al .

Journal of the European Academy of Dermatology and Venereology ◽

10.1111/jdv.17299 ◽

2021 ◽

Vol 35 (7) ◽

pp. 1418-1419

Author(s):

J. Kupfer ◽

C. Schut

Keyword(s):

Chronic Pruritus

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Pathophysiology and Treatment of Pruritus in Elderly

International Journal of Molecular Sciences ◽

10.3390/ijms22010174 ◽

2020 ◽

Vol 22 (1) ◽

pp. 174

Author(s):

Bo Young Chung ◽

Ji Young Um ◽

Jin Cheol Kim ◽

Seok Young Kang ◽

Chun Wook Park ◽

...

Keyword(s):

Skin Diseases ◽

Unknown Origin ◽

The Elderly ◽

Common Symptom ◽

Multiple Factors ◽

Signaling Mechanisms ◽

Novel Drugs ◽

Neuropathic Pruritus ◽

Chronic Pruritus

Pruritus is a relatively common symptom that anyone can experience at any point in their life and is more common in the elderly. Pruritus in elderly can be defined as chronic pruritus in a person over 65 years old. The pathophysiology of pruritus in elderly is still unclear, and the quality of life is reduced. Generally, itch can be clinically classified into six types: Itch caused by systemic diseases, itch caused by skin diseases, neuropathic pruritus, psychogenic pruritus, pruritus with multiple factors, and from unknown causes. Senile pruritus can be defined as a chronic pruritus of unknown origin in elderly people. Various neuronal mediators, signaling mechanisms at neuronal terminals, central and peripheral neurotransmission pathways, and neuronal sensitizations are included in the processes causing itch. A variety of therapies are used and several novel drugs are being developed to relieve itch, including systemic and topical treatments.

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The Evolving Approach to Treating Syndesmotic Injuries in the Elite Athlete: An International Perspective

Foot & Ankle Orthopaedics ◽

10.1177/2473011419s00034 ◽

2019 ◽

Vol 4 (4) ◽

pp. 2473011419S0003

Author(s):

Kenneth Hunt ◽

Shanthan Challa ◽

Pieter D’Hooghe ◽

Pam Kumparatana ◽

Phinit Phisitkul ◽

...

Keyword(s):

Return To Sport ◽

High Impact ◽

Optimal Treatment ◽

The Body ◽

Return To Play ◽

Considerable Variability ◽

Fixation Device ◽

Flexible Devices ◽

Fixation Devices ◽

Rehabilitation Protocols

Category: Ankle, Sports Introduction/Purpose: There exists little consensus regarding optimal treatment protocols for syndesmotic injuries. Orthopaedic clinicians have implemented a variety of treatment strategies, ranging from immobilization to screw fixation to new flexible fixation devices. While the body of literature is growing with regard to both the biomechanics and clinical outcomes for various constructs and rehabilitation protocols, there is little consensus on the optimal treatment and return to sport strategy for these injuries. We endeavored to assess current approaches to syndesmotic injures by orthopedic foot and ankle specialists around the world in 6 athlete scenarios with increasing degree of injury. Commensurate with the lack of available data to guide treatments, we hypothesize that there will be variability in the treatment and management strategies for syndesmotic injuries. Methods: A REDcap survey was created with 27 questions, including respondent demographics, indications for treatment of syndesmotic injuries, preferred treatment, preferred technique for repairing the syndesmosis and post-operative management. Respondents were asked to choose their preferred fixation device and post-operative return to play protocols in six different athlete scenarios (moderate impact, high impact and very high impact and each with/without complete deltoid injury). The survey was disseminated among the memberships of 18 North American and International medical societies. Society members were surveyed via three emails disseminated 2 weeks apart. Frequencies and percentages were calculated for all categorical responses. Results: A total of 596 providers responded to the survey, including 337 American surgeons and 259 members of various international societies. There was a 70% survey completion rate with a wide geographic distribution among respondents. Flexible devices were the preferred fixation construct (48.1%), followed by screws (27.5%), hybrid fixation (18.5%) and other (5.9%). There was a higher preference for flexible devices among sports medicine trained providers. 62% of respondents noted that their rehabilitation protocols would not change for each athlete scenario. Considerable variability was present in anticipated full return to sport, ranging from immediately following injury to 6 months post-op (Fig 1). One-third of respondents indicated that they repair the deltoid greater than 50% of the time when injured. Conclusion: We found a wide variety of indications and treatment constructs employed by orthopaedic surgeons for athletes with ligamentous syndesmotic injuries requiring fixation. Although, flexible fixation devices are the preferred among all respondents but there was a considerable variability in device choices. Fellowship training also appears to affect the preferred fixation device choice. There also exists substantial variability in expected return to play for every athlete scenario (Fig 1). The diversity in approaches and post-operative recommendations underscores the need for evidence-based guidelines to inform management of syndesmotic injuries.

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723 Racial differences in the health-related quality of life of chronic pruritus patients

Journal of Investigative Dermatology ◽

10.1016/j.jid.2020.03.736 ◽

2020 ◽

Vol 140 (7) ◽

pp. S97

Author(s):

K. Whang ◽

Y. Semenov ◽

R. Khanna ◽

K. Williams ◽

V. Mahadevan ◽

...

Keyword(s):

Quality Of Life ◽

Racial Differences ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

Chronic Pruritus

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Usability of Validated Sleep-assessment Questionnaires in Patients with Chronic Pruritus: An Interview-based Study

Acta Dermato Venereologica ◽

10.2340/00015555-2947 ◽

2018 ◽

Vol 98 (8) ◽

pp. 722-727 ◽

Cited By ~ 5

Author(s):

T Suilmann ◽

C Zeidler ◽

N Osada ◽

C Riepe ◽

S Ständer

Keyword(s):

Sleep Assessment ◽

Chronic Pruritus

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Effects on Performance of Variable Eccentric Loads during Depth Jumps

Journal of Sport Rehabilitation ◽

10.1123/jsr.4.1.31 ◽

1995 ◽

Vol 4 (1) ◽

pp. 31-41 ◽

Cited By ~ 1

Author(s):

James C. Radcliffe ◽

Louis R. Osternig

Keyword(s):

Body Weight ◽

Small Proportion ◽

Small Amplitude ◽

Vertical Jump ◽

Considerable Variability ◽

Large Depth ◽

Jumping Performance ◽

Squat Exercise ◽

Healing Tissue ◽

Extreme Care

Seventy subjects were tested for (a) percent body weight controlled (lowered and raised) by the lower extremities via parallel squat exercise, (b) maximum vertical jump-reach, and (c) maximal depth jump-reach from six heights ranging from 0.30 to 1.05 m. The results suggest that maximum parallel squat performance represents a small proportion (8%) of the variance contributing to controlling increasing depth jump heights and that specific improvement in jumping performance may be achieved by relatively small amplitude prestretch movements rather than large depth jump heights. The implications of the present findings for the use of depth jumping in conditioning and rehabilitative protocols are that (a) extreme care must be exercised in selecting jump heights, as there is considerable variability in individual tolerance to a given height, and (b) depth jumping should be contraindicated in cases where high impulse loads can disrupt healing tissue and, if it is used in postinjury situations, should be reserved for the end phase of rehabilitation.

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