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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.

journal of the european academy of dermatology and venereology

Relations between a standardized experimental stressor and cutaneous sensory function in patients with chronic pruritus and healthy controls: an experimental case–control study