Hydroxyethyl starch-induced pruritus relieved by a combination of menthol and camphor.
Hydroxyethyl starch is a key component of many colloid volume expanders used in hypovolemic shock and otologic disease. Pruritus is a common side effect. Histopathology reveals multiple cytoplasmic vacuoles in dermal macrophages, endothelial cells, and perineural cells with electron-dense foreign material within the said vacuoles. Although classically refractory to treatment with corticosteroids and antihistamines, some benefit has been achieved with capsaicin, ultraviolet light therapy, and oral naltrexone. We present a case responsive to menthol and camphor and discuss the possible therapeutic mechanism.
Haught
Justin M
JM
Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
Jukic
Drazen M
DM
English
Joseph C
JC
D000287:Administration, Topical; D000328:Adult; D000784:Aortic Dissection / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery; D002164:Camphor / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000009:adverse effects*; D008297:Male; D008610:Menthol / Q000008:administration & dosage*; D010952:Plasma Substitutes / Q000009:adverse effects*; D011537:Pruritus / Q000139:chemically induced* / Q000188:drug therapy* / Q000473:pathology; D012867:Skin / Q000648:ultrastructure
D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D008610:Menthol; D002164:Camphor