Topical Treatment of Pruritic Skin Disease and the Role of Community Pharmacists

Research output: Contribution to journalArticle

Abstract

Itching, or pruritus, can be defined as an unpleasant sensation that evokes the desire to scratch. Pruritus is most commonly associated with a primary skin disorder such as atopic dermatitis (AD), psoriasis, etc., and can have a major impact on the quality of life of those patients. Itch-induced scratching can further damage the skin barrier, leading to a worsening of symptoms. For that reason, it is important to manage pruritus. Topical glucocorticoids are commonly the first-line therapy in the management of AD and psoriasis patients. We found that topical glucocorticoids induce pruritus in mice under certain conditions. Topical glucocorticoids may induce pruritus in a mouse model of allergic contact dermatitis via inhibition of prostaglandin (PG)D2 production in antigen-mediated activated mast cells in the skin. Additionally, topical glucocorticoids do not induce pruritus in healthy skin. These results indicate the importance of controlling skin inflammation to a healthy level by applying sufficient quantities of glucocorticoids to avoid glucocorticoid-induced pruritus. However, topical "steroid phobia" is common in Japan, and most patients apply inadequate amounts of topical glucocorticoids for this reason. This may cause glucocorticoid-induced pruritus in patients by prolonging the skin inflammation. We conducted a survey regarding community pharmacists' instructions on the application quantity of topical glucocorticoids and found that most community pharmacists have experienced inappropriate instructions concerning this point.

Original languageEnglish
Pages (from-to)1563-1567
Number of pages5
JournalYakugaku zasshi : Journal of the Pharmaceutical Society of Japan
Volume139
Issue number12
DOIs
Publication statusPublished - 2019 Jan 1

Keywords

  • fingertip unit
  • pharmacist
  • prostaglandin D2
  • pruritus
  • topical steroid

ASJC Scopus subject areas

  • Pharmacology
  • Pharmaceutical Science

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