Abstract
Background
Aquagenic pruritus is an intense prickling sensation that develops in affected individuals immediately after contact with water at any temperature. It is most commonly associated with polycythemia rubra vera. Common but often ineffective treatments include anticholinergics and antihistamines. Other moderately successful treatments include capsaicin cream, UVB phototherapy, and sodium bicarbonate bath water.
Objective
In this case report we describe a 55-year-old female with severe itching following showers. Underlying causes were ruled out with a series of blood tests, a chest X-ray, and serum protein electrophoresis. After multiple treatment failures, her itching was relieved with naltrexone.
Conclusion
Endogenous opiates, like naltrexone, can modify pruritus by influencing the peripheral and central sensation of itch. It has been found to be successful in suppressing the perception of pruritus from many diverse origins including aquagenic pruritus.
Antécédents
Aquagenic pruritus est une sensation intense de picotement qui apparaît immédiatement après le contact avec 1’eau, peu importe sa température. Elle est fréquemment associée à la polycythémie vraie. Les traitements courants, mais souvent inefficaces, comprennent les anticholinergiques et les antihistaminiques. D’autres traitements à succès modéré comprennent les crèmes de capsicine, la photothérapie aux rayons UV et les bains au bicarbonate de soude.
Objectifs
Le présent rapport de cas décrit la situation d’une femme âgée de 55 ans qui souffre de démangeaison aiguë après les douches. Une série de prélèvements sanguins, des radiographies pulmonaires et des électrophorèses des protéines sériques ont permis d’éliminer les causes sous-jacentes possibles. Après l’échec de multiples traitements, sa démangeaison a été soignée grâce au naltrexone.
Conclusion
Les agents endogènes opiacés, tels que naltrexone, peuvent modifier le prurit en agissant sur la sensation centrale et périphérique de démangeaison. Ce traitement semble efficace sur toute sorte de prurit, y compris le prurit lié à 1’eau.
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Ingber, S., Cohen, P.D. Successful Treatment of Refractory Aquagenic Pruritus with Naltrexone. J Cutan Med Surg 9, 215–216 (2005). https://doi.org/10.1007/s10227-005-0144-x
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DOI: https://doi.org/10.1007/s10227-005-0144-x