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Acupuncture compared with oral antihistamine for type I hypersensitivity itch and skin response in adults with atopic dermatitis – a patient‐ and examiner‐blinded, randomized, placebo‐controlled, crossover trial
Author(s) -
Pfab F.,
Kirchner M.T.,
HussMarp J.,
Schuster T.,
Schalock P. C.,
Fuqin J.,
Athanasiadis G. I.,
Behrendt H.,
Ring J.,
Darsow U.,
Napadow V.
Publication year - 2012
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/j.1398-9995.2012.02789.x
Subject(s) - cetirizine , medicine , placebo , antihistamine , crossover study , acupuncture , randomized controlled trial , atopic dermatitis , anesthesia , gastroenterology , dermatology , alternative medicine , pathology
Background Itch is the major symptom of atopic dermatitis ( AD ). Acupuncture has been shown to exhibit a significant effect on experimental itch in AD . Our study evaluated acupuncture and antihistamine itch therapy (cetirizine) on type I hypersensitivity itch and skin reaction in AD using a patient and examiner‐blinded, randomized, placebo‐controlled, crossover trial. Methods Allergen‐induced itch was evaluated in 20 patients with AD after several interventions in separate sessions: preventive (preceding) and abortive (concurrent) verum acupuncture ( VA p and VA a), cetirizine (10 mg, VC ), corresponding placebo interventions (preventive, PA p, and abortive, PA a, placebo acupuncture; placebo cetirizine pill, PC ) and a no‐intervention control ( NI ). Itch was induced on the forearm and temperature modulated over 20 min, using our validated model. Outcome parameters included itch intensity, wheal and flare size and the D 2 attention test. Results Mean itch intensity ( SE : 0.31 each) was significantly lower following VA a (31.9) compared with all other groups ( PA a: 36.5; VC : 36.8; VA p: 37.6; PC : 39.8; PA p: 39.9; NI : 45.7; P < 0.05). There was no significant difference between VA p and VC ( P > 0.1), although both therapies were significantly superior to their respective placebo interventions ( P < 0.05). Flare size following VA p was significantly smaller ( P = 0.034) than that following PA p. D 2 attention test score was significantly lower following VC compared with all other groups ( P < 0.001). Conclusions Both VA and cetirizine significantly reduced type I hypersensitivity itch in patients with AD , compared with both placebo and NI . Timing of acupuncture application was important, as VA a had the most significant effect on itch, potentially because of counter‐irritation and/or distraction. Itch reduction following cetirizine coincided with reduced attention.