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Factors that Exacerbate Itching in Patients with Atopic Dermatitis

  • Hiroyuki MurotaEmail author
  • Ichiro Katayama
Chapter

Abstract

Patients with atopic dermatitis (AD) exhibit different clinical symptoms, progression, and treatment responses during childhood and adulthood. In adults, itching of the skin is followed by the formation of well-circumscribed plaques or polymorphous dermatoses at the site of itching and is often accompanied by dryness. AD patients show hypersensitivity to various external stimuli that can exacerbate itching, such as heat and perspiration, which leads to scratching and further aggravation of skin lesions. This hypersensitivity exhibited by AD patients may arise from abnormal elongation of sensory nerves into the epidermis as well as sensitization of peripheral or central nerves. Itching can worsen when excess sweat is left on the skin or when insufficient sweating results in heat retention. Endogenous factors such as cytokines and chemical messengers can also induce itch by stimulating nerve fibers in the skin. Itching can be caused not only by stimulation of the skin surface but also by visual and auditory stimulation, with psychologically induced “contagious itch” being stronger in AD patients than in healthy individuals. Furthermore, itch often increases in the evening when sympathetic nerve activity decreases. This chapter discusses factors that exacerbate itching in AD and guidance for the proper management of the disease.

Keywords

■■■ Atopic dermatitis Itch Exacerbate Dry skin Temperature Sweat Psychological factors 

Notes

Conflict of Interest

The authors have nothing to declare.

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© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Dermatology, Department of Integrated Medicine, Graduate School of MedicineOsaka UniversityOsakaJapan

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