Itch and eczema

Eczema/dermatitis belongs to the most pruritic of skin diseases. Pruritogenic mediators in the skin are still mostly unknown. Recent studies, however, have shown that the histamine 4 receptor plays an important role in itch pathophysiology; tryptase and IL-31 are also involved in atopic eczema itch. Differences in itch perception and itch kinetics between healthy volunteers and eczema patients point towards ongoing central nervous inhibitory activity in patients. Questionnaire studies reported comparatively higher loads in affective items chosen by patients with atopic eczema. In the concept of eczema patient management, the therapy of clinical pruritus has to consider pathophysiology and perception by combining topical and systemic treatment.