Do you ever wonder what’s in the tool box of an itch expert like Baltimore dermatologist Dr. Shawn Kwatra? Next Steps in Derm, in partnership with ODAC Dermatology, Aesthetic & Surgical Conference, interviewed Dr. Kwatra, who outlined the therapies he uses, including injections, topicals and oral pills. Watch as Dr. Kwatra outlines why determining the type of itch is imperative to selecting the appropriate treatment. Learn which treatment option may bring the fastest relief. Plus hear Dr. Kwatra share the results of several recent studies on itch treatments, including abrocitinib, ketamine infusions and bedside bupivacaine.
Further Reading
Check out the studies Dr. Kwatra mentioned in his interview:
United States expert panel consensus on uniform nomenclature and diagnosis for neuropathic pruritus
Kwatra, Shawn G., et al. “United States expert panel consensus on uniform nomenclature and diagnosis for neuropathic pruritus.” Itch 9.1 (2024): e0073.
Abstract
Importance:
Neuropathic pruritus is a debilitating condition lacking a uniform approach to nomenclature and diagnosis.
Objective:
A panel of dermatologist experts in pruritus was convened to develop definitions, diagnostic recommendations, and treatment guidelines for neuropathic pruritus.
Evidence review:
A roundtable discussion of 10 experts was conducted on November 3, 2021, via the Zoom platform. This study follows the Standards for Reporting Qualitative Research reporting guidelines for qualitative studies. A systematic review of prior literature on the definition, scope, diagnostic, and treatment was performed, looking at sources of treatment from 1991 to 2021. Consensus was defined as >70% agreement for acceptance of a definition or recommendation. A draft of evidence was subjected to revision by all participants and was endorsed by all participants.
Findings:
The roundtable identified definitions for neuropathic pruritus, which included different forms of the condition based on cause and presentation such as brachioradial pruritus, notalgia paresthetica, and scalp pruritus. Diagnostic and treatment guidelines were also established. Limitations of this process included lack of randomized controlled studies. These recommendations are also based on expert consensus and must be further supported by evidence-based outcomes research.
Conclusions:
Neuropathic pruritus contains numerous subtypes, causes, diagnostic methods, and treatment modalities. The recommendations developed by this panel are meant to serve as shared nomenclature for future clinical studies.
Ketamine Infusions for Treatment-Resistant Neuropathic Pruritus
Kwatra, Shawn G., et al. “Ketamine infusions for treatment-resistant neuropathic pruritus.” JAMA dermatology 159.9 (2023): 1011-1012.
Kambala, Anusha, et al. “Bedside greater occipital nerve block with bupivacaine for the treatment of recalcitrant scalp pruritus.” JAAD Case Reports 44 (2024): 77-81.
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