Life-threatening blood loss from scratching provoked by pruritus in the bulky perineal nevocytoma variant of giant congenital melanocytic nevus in a child.
We describe a 3-year-old girl with intractable, debilitating pruritus associated with a giant congenital melanocytic nevus, resulting in life-threatening anemia from extensive bleeding skin excoriations. Multiple conventional oral and topical antipruritic medications failed to provide relief, but the patient was successfully treated with the selective serotonin 5-hydroxytryptamine type 3 inhibitor ondansetron, suggesting a serotonin-related mechanism to her pruritus.
Feng
Jing
J
Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut 06520-8059, USA.
Sethi
Aisha
A
Reyes-Múgica
Miguel
M
Antaya
Richard
R
D001003:Anal Canal; D000740:Anemia / Q000209:etiology; D000982:Antipruritics / Q000627:therapeutic use; D002675:Child, Preschool; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D009508:Nevus, Pigmented / Q000150:complications* / Q000151:congenital*; D017294:Ondansetron / Q000627:therapeutic use; D011537:Pruritus / Q000150:complications* / Q000188:drug therapy; D012702:Serotonin Antagonists / Q000627:therapeutic use; D012878:Skin Neoplasms / Q000150:complications* / Q000151:congenital*; D014844:Vulva
D000982:Antipruritics; D012702:Serotonin Antagonists; D017294:Ondansetron