Chronic pruritus: a paraneoplastic sign
Article first published online: 3 NOV 2010
© 2010 Wiley Periodicals, Inc.
Volume 23, Issue 6, pages 590–596, November/December 2010
How to Cite
Yosipovitch, G. (2010), Chronic pruritus: a paraneoplastic sign. Dermatologic Therapy, 23: 590–596. doi: 10.1111/j.1529-8019.2010.01366.x
- Issue published online: 3 NOV 2010
- Article first published online: 3 NOV 2010
- itch pathophysiology;
- kappa opioids;
- paraneoplastic itch
Chronic itch could be a presenting sign of malignancy. Pruritus of lymphoma is the common prototype of paraneoplastic itch and can precede other clinical signs by weeks and months. Paraneoplastic pruritus has also been associated with solid tumors and is an important clinical symptom in paraneoplastic skin diseases such as erythroderma, Grovers disease, malignant acanthosis nigricans, generalized granuloma annulare, Bazex syndrome, and dermatomyositis. In any case with high index of suspicion a thorough work-up is required. This review highlights the association between itch and malignancy and presents new findings related to pathophysiological mechanisms and the treatment of itch associated with malignancy. Combinative therapies reducing itch sensitization and transmission using selective serotonin and neuroepinephrine reuptake inhibitors, Kappa opioids, and neuroleptics are of prime importance in reducing this bothersome symptom.