Acta dermato-venereologica
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Acta Derm. Venereol. · Jan 1990
Clinical Trial Controlled Clinical TrialPlasma concentrations and analgesic effect of EMLA (lidocaine/prilocaine) cream for the cleansing of leg ulcers.
Plasma concentrations of lidocaine and prilocaine were assessed in 8 patients after the application of 8-10 g EMLA 2% cream for 60 min to leg ulcers measuring 31-80 cm2. Maximum individual plasma concentrations were 205 ng/ml for lidocaine and 79 ng/ml for prilocaine, which is twenty times lower than those associated with toxicity. ⋯ The ulcer was covered with a thick layer of cream for 30 min before four consecutive debridements 1-4 days apart. While the 2% and 5% creams had similar analgesic effects post-cleansing pain tended to be more frequent with the 2% cream.
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Acta Derm. Venereol. · Jan 2008
ReviewBiopsychosocial mechanisms of chronic itch in patients with skin diseases: a review.
Itch is a major feature of many skin diseases, which adversely affects patient's quality of life. Besides disease severity, psychophysiological factors have been proposed to influence the itch sensation. In this review the evidence for a biopsychosocial model of itch is described, focusing in particular on evidence for the effects of personality characteristics, external stressors, cognitive, behavioural and social factors, and the possible mediating role of physiological processes. ⋯ Furthermore, cognitive factors, such as helplessness and worrying, and the behavioural response of scratching have been indicated as possible worsening factors. Overall, findings are in favour of a biopsychosocial model for the itch sensation. However, there is a strong need for more, methodologically sound research in order fully to understand the processes underlying the itch sensation.
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Acta Derm. Venereol. · Mar 1996
Review Case ReportsA case of actinic granuloma associated with periumbilical perforating pseudoxanthoma elasticum.
We report an unusual case of actinic granuloma of the face and periumbilical perforating pseudoxanthoma elasticum located superior to the umbilicus in a 57-year-old Korean woman. Histopathologically, these two dermatoses have a similar degeneration of elastic fibers, but they show different host reactions to the altered elastic fibers. In the actinic granuloma, actinically damaged elastic fibers were followed by granulomatous infiltration on the sun-exposed area, while in the perforating pseudoxanthoma elasticum, the altered elastic fibers induced a foreign body reaction, with subsequent transepidermal elimination. This is the first case report showing both actinic granuloma and periumbilical perforating pseudoxanthoma elasticum in the same patient, which suggests that the basic mechanism eliciting these dermatoses is similar.
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Acta Derm. Venereol. · Mar 1999
Clinical Trial Controlled Clinical TrialEffect of EMLA pre-treatment on capsaicin-induced burning and hyperalgesia.
Capsaicin, which has been studied extensively as a treatment for itch and several chronic pain disorders, induces burning during the first week of therapy, causing a substantial percentage of patients to discontinue treatment prematurely. We examined whether pre-treatment with the topical anesthetic EMLA reduces the burning sensation induced by capsaicin and alters capsaicin effects on thermal sensation and pain thresholds. Healthy adult volunteers participated in the single-blind, 6-day study. ⋯ Cold pain hypoalgesia persisted in both forearms. The warmth sensation threshold was significantly higher on the EMLA-pre-treated forearm after 1 and 5 days of treatment. In conclusion, pre-treatment with EMLA significantly reduced the burning sensation from capsaicin and attenuated heat hyperalgesia during treatment.
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Acta Derm. Venereol. · Aug 2017
Comparative StudyInvolvement of µ-opioid Receptors and κ-opioid Receptors in Itch-related Scratching Behaviour of Imiquimod-induced Psoriasis-like Dermatitis in Mice.
The pathogenesis of psoriatic itch is poorly understood. The aim of this study was to investigate the involvement of opioid receptors in scratching behaviour of imiquimod-induced psoriasis-like dermatitis model mice. Topical application of 5% imiquimod cream to the rostral back skin of mice induced antihistamine-resistant scratching behaviour. ⋯ In contrast, the expression of κ-opioid receptor (KOR) protein decreased in the DRG and spinal cord of imiquimod-treated mice, and was undetectable in the epidermis of both groups. Topical or intraperitoneal administration of the MOR antagonist naloxone and oral administration of the centrally acting KOR agonist ICI-199,441 inhibited scratching behaviour, whereas oral administration of the peri-pherally-selective KOR agonist asimadoline did not. These results suggest that peripheral and central MOR and central KOR may be involved in the modulation of scratching behaviour in imiquimod-treated mice.