Historical background of itch.

Itch as a disease, and especially as a symptom, was the object of medical and scientific curiosity for centuries. The reluctance of historians to focus on the history of itch relates to its nature as a subjective symptom. After all, how can historians have known what itch really felt like in previous centuries? Since the establishment of dermatology as an independent discipline of medicine in the middle of the nineteenth century, itch has become a subject of investigation in its own right. This chapter summarises research we conducted on the medical history of itch in ancient medicine and up through the twentieth century.

[Historical aspects concerning the symptom of itch in the German-speaking region (1850-1939)]. / Medizinhistorische Aspekte zum Symptom "Pruritus" im deutschsprachigem Raum (1850-1939).

Since the establishment of dermatology as an independent discipline of medicine in the middle of the 19th century, pruritus or itch has been a subject of research. The goals were to discover the etiology of pruritus, to develop useful therapies and to achieve a classification within the system of skin diseases. Looking at historical aspects of pruritus demonstrates just how difficult it has been to approach this problem. The difficulties even influence present day pruritus research. For example, there is no definite international standard of pruritus. Etiology-oriented classifications have dominated, but have recently been supplemented by a clinical classification.

[About Itching and scabies. Pruritus in medical history--from ancient world to the French revolution]. / Uber Jucken und Krätze. Pruritus im Lauf der Medizingeschichte--von der Antike bis zur Französischen Revolution.

Pruritus (itching) as a disease state and especially as a disease symptom has been object of medical and scientific descriptions and examinations in all epochs since the antiquity and in different cultural periods. Antiquity was dominated by observations and descriptions but during the course of medical history and particularly since the establishment of dermatology, more and more emphasis has been placed on classification and etiologic research.

Mechanisms of pain and itch caused by herpes zoster (shingles).

UNLABELLED: Study of humans with shingles or postherpetic neuralgia (PHN) is providing insights into pain mechanisms. Shingles pain is a combination of normal and neuropathic pain that reflects acute tissue and neural injury. PHN pain, which lasts after tissues have healed, is caused by persistent neural injuries. Spontaneous C-nociceptor activity has been documented in painful polyneuropathies and probably occurs in shingles as well, although there are no microneurographic studies of either shingles or PHN. It is uncertain if this persists in PHN since pathological examination of PHN-affected nerves and ganglia show chronic neuronal loss and quiescent scarring without inflammation. Skin-biopsy study has correlated the presence of PHN with the severity of persistent distal nociceptive axon loss, and autopsy has correlated pain persistence with segmental atrophy of the spinal cord dorsal horn, highlighting the importance of central responses to nerve injury. Pathological studies of tissues from patients with trigeminal neuralgia suggest that brief lancinating pains reflect ephaptic neurotransmission between adjacent denuded axons. The mechanisms of chronic spontaneous pain and mechanical allodynia remain uncertain despite considerable indirect evidence from animal models. Postherpetic itch is presumably caused by unprovoked firing of the peripheral and/or central neurons that mediate itch. If it occurs in neurons innervating skin left severely deafferented from shingles ("numb"), patients can give themselves painless injuries from scratching. Further human study, by electrophysiological recording, by structural and functional imaging, and by autopsy, should continue to provide much-needed insights. PERSPECTIVE: Many patients continue to have chronic pain and/or itch after shingles that is unrelieved by current treatments. Many will gladly volunteer for clinical studies, including autopsy, to try and improve understanding of these common and disabling conditions. Their prevalence makes highly powered studies feasible. Funding and organization are the current bottlenecks.

The "army itch:" a dermatological mystery of the American Civil War.

The army itch was a chronic, severely pruritic dermatosis which first appeared among soldiers and some civilians early in the American Civil War (1861-1865). As the war progressed, so did army itch, becoming epidemic in the Potomac Valley of Maryland in 1862 and in Virginia in 1864. Immediately after the war, civilian cases traceable to contact with returning soldiers focused attention on the disorder, but the postwar outbreaks were short-lived and the army itch disappeared by the end of 1867. The origin of army itch eluded medical observers of the time, though many considered epidemic scabies to be the cause. Many cases of army itch were successfully treated with scabicides, but the disease had a well-deserved reputation for intractability. After a review of the chronology of army itch and excerpts from the writings of physicians who saw and treated the disease, it is possible to conclude that army itch was epidemic scabies, though the clinical picture was frequently confounded by coexisting pediculosis, prurigo, and other pruritic dermatoses.

Some historical and epistemological remarks on itch and pruritus.

Although very common, itch is very hard to describe. It can be considered as one of the most distressing physical sensations we experience. Going back historically, old Latin and Greek writers cited it in ancient papers. So, etymology is of central importance to investigation in the field of itch, regarding the formation of a word with antique origins and different meanings. Scientists, poets, and painters for centuries tried to describe and represent itch. The study of their work reveals the development of the itch's significance. Today, a clinically relevant distinction defines pruritus and itch as two different sensations. Moreover, some terms like hyperknesis, alloknesis, atmoknesis, protopathic itch, and epicritic itch are described to approaching the complexity of this sensation and are utilized in clinical practice.

Nonrashes. 5. Atmoknesis: pruritus provoked by contact with air.

Atmoknesis, itching provoked by open exposure of the skin to air after undressing, is a common and distressing symptom. It occurs in many patients with psoriasis and atopic dermatitis, and in elderly patients with aquagenic pruritus. It also occurs in some patients with underlying systemic causes of generalized pruritus, such as hepatobiliary disease. It does not seem to be an important feature of certain other pruritic skin diseases such as dermatitis herpetiformis and bullous pemphigoid.