Active Ingredients: Hydroxyzine
Treatment with topical corticosteroids, emollients, and oral cetirizine hydrochloride 10 mg once daily also did not improve his symptoms. Broadband UV-B therapy 3 times a week for 6 weeks, a reducing course of oral prednisolone for 8 weeks, oral dothiepin hydrochloride for 10 weeks, and 2 mg of ketotifen fumarate twice daily for 4 months also had no effect.
Therapeutic challenge Treatment of generalized pruritus of unknown origin can be challenging, and topical and systemic agents have been used successfully. Topical agents include coolants menthol, 3 anesthetic agents a eutectic mixture of local anesthetics, 4 antihistamines doxepin hydrochloride, 5 corticosteroids, 6 and substance P depletors capsaicin.
Solution Recently, gabapentin, an antiepileptic agent, has been reported to be an effective antipruritic agent in brachioradial pruritus.
Both patients had an excellent response, with complete control of the itching within the first month.
They have continued with a maintenance dosage based on symptom control of gabapentin and have remained symptom free for longer than 9 months, with no adverse effects due to the medication.
Comment Pruritus is a distinct sensation that evokes a desire to scratch. It is transmitted by C fibers that end in specialized receptors localized on the multimodal endings close to the dermoepidermal junction.
These fibers synapse in a specific class of dorsal horn neurons and ascend up the spinal cord in the lateral spinothalamic tract. Supraspinal processing of the itching sensation is attributed to activation of the anterior cingulate cortex, supplementary motor area, and inferior parietal lobe in the brain, with a left hemisphere predominance.
A recent study 8 demonstrated the efficacy of paroxetine a selective serotonin reuptake inhibitor in treating generalized pruritus by its binding to serotonin transporters on presynaptic nerve endings.
This prevents neural reuptake of serotonin, which initially increases the amount of serotonin in the synapse. With prolonged reuptake inhibition, the postsynaptic 5-HT receptors are downgraded, and serotonin release is decreased.
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Continuing in the gallery are constellations featuring pieces by artists including American contemporary artist Glenn Ligon b.