Post herpetic itching--a treatment dilemma.
OBJECTIVE
To present a case of severe disabling postherpetic itching (PHI) and discuss possible mechanisms and management.


METHODS
We report on a 22-year-old male patient with a history of non-Hodgkin lymphoma, chronic renal failure peritoneal dialysis dependent, presented with a disabling pruritus around his left eye and forehead. Two months before, he was diagnosed with herpes zoster ophtalmicus. His itching intensity was 10/10 on a visual analog scale and he reported no pain. The neurologic examination showed a hyposensitivity to touch around his left eye.


RESULTS
Our patient suffered of PHI who responded successfully to a combination of antihistamine and an antiepileptic agent.


CONCLUSIONS
The mechanism of postherpetic neuralgia and PHI are not well understood and no single best treatment for postherpetic neuralgia and PHI is known. Clinical experience suggested that neuropathic itch may be more resistant to treatment than neuropathic pain. This immunocompromized patient with a severe disabling PHI responded to antihistaminic and anticonvulsant treatment.
Semionov
Valentina
V
Pain and Palliative Care Unit, Siaal Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev, Clalit Health Services-Southern District, Beer-Sheva, Israel. valsem2002@yahoo.com
Shvartzman
Pesach
P
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D006563:Herpes Zoster Ophthalmicus / Q000150:complications*; D006634:Histamine H1 Antagonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D051474:Neuralgia, Postherpetic / Q000188:drug therapy* / Q000209:etiology*; D010147:Pain Measurement
D000927:Anticonvulsants; D006634:Histamine H1 Antagonists