title: Post burn pruritus--a review of current treatment options.
abstract: Post burn pruritus is a well recognised symptom in almost all burn patients. Yet, there is insufficient awareness about the etiopathogenesis and a lack of a systematic approach in the assessment and treatment of this distressing symptom. The current standard therapies include antihistamines, which are effective as sole therapy in only 20% patients, and emollients. There is a lacunae of clear consensus on the care of patients not responding to antihistamines. We review the literature on the etiology and pathogenesis of post burn pruritus, which has both central and peripheral pathways. The published studies on the currently available therapeutic options to treat itch in burns are discussed. On the basis of current evidence in literature, gabapentin used in the treatment of neuropathic pain, has demonstrated great promise, and is suggested as the next option for this subset of patients, not relieved with antihistamines.
authors.affiliation: Department of Plastic Surgery, Christian Medical College, Vellore, Tamil Nadu, India. drjewelpaul@gmail.com
authors.forename: Jewel Raj
authors.initials: JR
authors.lastname: Zachariah
authors.forename: Aravind Lakshmana
authors.initials: AL
authors.lastname: Rao
authors.forename: Ratna
authors.initials: R
authors.lastname: Prabha
authors.forename: Ashish Kumar
authors.initials: AK
authors.lastname: Gupta
authors.forename: M Kingsly
authors.initials: MK
authors.lastname: Paul
authors.forename: Shashank
authors.initials: S
authors.lastname: Lamba
mesh_terms: D000588:Amines / Q000493:pharmacokinetics / Q000627:therapeutic use; D000700:Analgesics / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002056:Burns / Q000150:complications*; D003509:Cyclohexanecarboxylic Acids / Q000493:pharmacokinetics / Q000627:therapeutic use; D004643:Emollients / Q000627:therapeutic use; D000077206:Gabapentin; D006633:Histamine Antagonists / Q000627:therapeutic use*; D006801:Humans; D036421:Nerve Fibers, Unmyelinated / Q000502:physiology; D011537:Pruritus / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D005680:gamma-Aminobutyric Acid / Q000493:pharmacokinetics / Q000627:therapeutic use
chemical_list: D000588:Amines; D000700:Analgesics; D003509:Cyclohexanecarboxylic Acids; D004643:Emollients; D006633:Histamine Antagonists; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin