New research changes approach to managing itch

“Approach to the Red, Itchy Patient,” (S010) will be presented from 2 to 5 p.m. Saturday in Grand Ballroom West.

“Approach to the Red, Itchy Patient,” (S010) will be presented from 2 to 5 p.m. Saturday in Grand Ballroom West.

There is more to itching than many dermatologists realize. Not only is itching one of the most intensely unpleasant sensations known, its causes and treatments are far more varied than were recognized just a few years ago. Itch is the No. 1 item on the Academy’s research agenda.

“Itch has been interwoven with dermatology for centuries, but our understanding of itch has been advancing tremendously over the past decade,” said Gil Yosipovitch, MD, professor and chair of dermatology and director of the Temple Itch Center at the Temple University School of Medicine. “Until recently, dermatologists would give only antihistamines or topical steroids for itch. Now we know better.”

Gil Yosipovitch, MD

Gil Yosipovitch, MD

Itching has long been overshadowed by pain as a focus for research and treatment. At one point, itching was dismissed as nothing more than a mild form of pain. More recent research has identified a growing network of nerves, molecules, pathways, and receptors that are specific for itch and amenable to targeted therapy.

Dr. Yosipovitch is course director for Advice From the Experts: “Approach to the Red, Itchy Patient,” (S010), which will be presented from 2 to 5 p.m. Saturday in Grand Ballroom West. Six dermatologists and itch specialists will explore the state of the art in accurately diagnosing and managing some of the most common forms of itching.

  • Dr. Yosipovitch will focus on the latest developments in the management of psoriatic itch.
  • Susan Nedorost, MD, professor of dermatology at Case Western Reserve University School of Medicine, will discuss the latest findings in systemic contact dermatitis that can lead to significant itching.
  • Sonia Stander, MD, professor of dermatology and neurodermatology, and head of the Interdisciplinary Competence Center for Chronic Pruritus at University Hospital, Munster, Germany, will share the latest findings on the management of prurigo nodularis. The itchy rash typical of this condition is not a primary rash but is secondary to the pathology.
  • Mario Lacouture, MD, founder of the Skin and Eye Reactions to Inhibitors of EGFR and Kinases Clinic at Memorial Sloan Kettering Cancer Center, will introduce the latest findings on itch resulting from new generations of targeted cancer therapies. Itch and itchy rash are among the most common adverse events associated with targeted cancer therapies using the latest generations of kinase inhibitors and epidermal growth factor receptor (EGFR) inhibitors, including the latest antimelanoma agents.
  • Sarina Elmariah, MD, PhD, an itch specialist at Massachusetts General Hospital, will discuss the practical side of managing itch.

“Every dermatologist knows atopic dermatitis, but do we really know how to address the itch component and make the differential diagnosis?” Dr. Yosipovitch asked. “Atopic eczema is undergoing significant advances in the way it is treated and targeted. The change is similar to what we have seen in psoriasis. Fifteen years ago, we had very few treatments in our armamentarium, but the field has completely changed. Itch is the number one complaint in eczema, and treatment of eczema is undergoing a very similar process right now.”

The symposium has been designed with the practicing dermatologist in mind, he said. Attendees can expect to hear about practical tips on clinical management tools, insights into new therapeutic agents, and guidance on new strategies to help deal with patient complaints about itch.

“We have created a potpourri of everyday problems that have new approaches,” Dr. Yosipovitch said. “Dermatologists should be aware of these new approaches and diagnoses that are going well beyond what have historically been our mainstay treatments.”

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