title: Neuropathic pain in post-burn hypertrophic scars: a psychophysical and neurophysiological study.
abstract: BACKGROUND
  Pain complicates hypertrophic post-burn pathologic scars (PPS) METHODS: To investigate the possible neuropathic origin of pain, 13 patients with painful PPS involving at least 1 hand underwent clinical examination, including the Douleur Neuropathique en 4 questions (DN4) questionnaire; median, ulnar, and radial nerve conduction studies (NCS); cold- (CDT) and heat-induced pain threshold evaluation by quantitative sensory testing; and cutaneous silent period (CSP) testing of the abductor pollicis brevis. Controls included 9 patients with non-painful PPS, 52 healthy subjects, and 28 patients with carpal tunnel syndrome (CTS).
  
  
  RESULTS
  All patients with painful PPS had possible neuropathic pain (DN4 score ≥4). NCS signs of CTS were similarly present in PPS subjects with or without pain. Hands with painful PPS had lower CDT and CSP duration, more frequent cold- and heat-pain hypesthesia, and more thermal allodynia than controls.
  
  
  CONCLUSIONS
  In PPS, possible neuropathic pain is associated with psychophysical and neurophysiological abnormalities suggestive of small-fiber damage.
authors.affiliation: Unit of Neurophysiology, Hospital CTO-Maria Adelaide, Torino, Italy. gianlucaisoardo@yahoo.it
authors.forename: Gianluca
authors.initials: G
authors.lastname: Isoardo
authors.forename: Maurizio
authors.initials: M
authors.lastname: Stella
authors.forename: Dario
authors.initials: D
authors.lastname: Cocito
authors.forename: Daniela
authors.initials: D
authors.lastname: Risso
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Migliaretti
authors.forename: Franco
authors.initials: F
authors.lastname: Cauda
authors.forename: Angela
authors.initials: A
authors.lastname: Palmitessa
authors.forename: Giuliano
authors.initials: G
authors.lastname: Faccani
authors.forename: Palma
authors.initials: P
authors.lastname: Ciaramitaro
mesh_terms: D000328:Adult; D002056:Burns / Q000150:complications*; D002349:Carpal Tunnel Syndrome / Q000503:physiopathology; D016022:Case-Control Studies; D017439:Cicatrix, Hypertrophic / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology; D009437:Neuralgia / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology*; D009482:Neurophysiology; D011601:Psychophysics; D011795:Surveys and Questionnaires