Weisshaar E, Szepietowski JC, Darsow U, Misery L, Wallengren J, Mettang T, Gieler U, Lotti T, Lambert J, Maisel P, Streit M, Greaves MW, Carmichael AJ, Tschachler E, Ring J, Ständer S.
European Guideline on Chronic Pruritus.
In cooperation with the European Dermatology Forum (EDF) and the European Academy of Dermatology and Venereology (EADV).
Acta Derm Venereol. 2012; 92: 563–581.
Chronic pruritus (CP) is a frequent symptom in the general population and in many skin and systemic diseases . Its frequency demonstrates a high burden and an impaired quality of life. This guideline addresses a symptom and not a disease. As a consequence of the diversity of possible underlying diseases, no single therapy concept can be recommended. Each form of pruritus has to be considered individually. There is still a significant lack of randomised controlled trials (RCT), that can be explained by the diversity and complexity of this symptom, multifactorial aetiologies of pruritus and the lack of well-defined outcome measures. To complicate matters, RCT exist for some types of pruritus, but with conflicting results. However, new therapies for improved medical care have been suggested. In addition, many expert recommendations are provided. The health care system in many countries and their social economic situation with constantly reducing financial resources increases the need for guidelines. These recommendations are based on a consensus of participating countries, while also allowing for country-specific treatment modalities, and health care structures. Furthermore, it should be appreciated that some topical and systemic therapies can only be prescribed “off-label” and require informed consent. If such “off-label” therapies cannot be initiated in the physician’s office, cooperation with a specialised centre for pruritus might be helpful.
This guideline addresses all medical disciplines that work with patients suffering from CP. This includes also entities defined by chronic scratch lesions such as prurigo nodularis and lichen simplex.
The guidelines are not only focussed on dermatology.
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