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Relations between a standardized experimental stressor and cutaneous sensory function in patients with chronic pruritus and healthy controls: an experimental case–control study
Author(s) -
Schneider G.,
Stumpf A.,
Burgmer M.,
Volmering L.,
Broecker P.,
Ständer S.
Publication year - 2018
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.15030
Subject(s) - medicine , quantitative sensory testing , trier social stress test , stressor , sensory system , sensitization , sensory threshold , sensitive skin , threshold of pain , pathophysiology , dermatology , fight or flight response , immunology , clinical psychology , neuroscience , psychology , biochemistry , chemistry , biology , gene , cognitive science
Background While chronic pruritus ( CP ) is a frequent symptom, many aspects of its underlying pathophysiological mechanisms still need elucidation. Research on sensory cutaneous function and on the influence of stress has been conducted mainly in patients with atopic dermatitis but is lacking for patients with CP . Objective To assess whether a standardized social stressor influences cutaneous sensory function in patients with CP in comparison with healthy controls ( HC ). Methods Case–control study; 33 CP and 30 HC were submitted to the standardized quantitative sensory testing protocol before and after the Trier Social Stress Test and 1 h later. Intraepidermal nerve fibre density ( IENFD ) was determined. Results Mechanical pain sensitivity and mechanical detection thresholds were significantly higher in CP than in HC , and mechanical detection thresholds increased more in CP than in HC over the three measurements. In both groups, cold pain threshold increased and heat pain threshold decreased from before to after the stress test and remained constant 1 h later. Only in CP , almost all QST tests induced at least a small amount of pruritus, which was not significantly altered by the stress test. IENFD in pruritic skin was significantly reduced in CP when compared to healthy controls. Conclusion Peripheral thermal sensory function was not altered in CP despite reduced IENFD in lesional skin, but we could demonstrate central sensitization processes specifically in CP and influences of an acute stressor inducing more sensitivity to thermal pain in both groups.