Valentina Semionov1, Pesach Shvartzman. 1. Pain and Palliative Care Unit, Siaal Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev, Clalit Health Services-Southern District, Beer-Sheva, Israel. valsem2002@yahoo.com
Abstract
OBJECTIVES: To present a case of severe disabling postherpetic itching (PHI) and discuss possible mechanisms and management. METHODS: We report on a 22-year-old male patient with a history of non-Hodgkin lymphoma, chronic renal failure peritoneal dialysis dependent, presented with a disabling pruritus around his left eye and forehead. Two months before, he was diagnosed with herpes zoster ophtalmicus. His itching intensity was 10/10 on a visual analog scale and he reported no pain. The neurologic examination showed a hyposensitivity to touch around his left eye. RESULTS: Our patient suffered of PHI who responded successfully to a combination of antihistamine and an antiepileptic agent. DISCUSSION: The mechanism of postherpetic neuralgia and PHI are not well understood and no single best treatment for postherpetic neuralgia and PHI is known. Clinical experience suggested that neuropathic itch may be more resistant to treatment than neuropathic pain. This immunocompromized patient with a severe disabling PHI responded to antihistaminic and anticonvulsant treatment.
OBJECTIVES: To present a case of severe disabling postherpetic itching (PHI) and discuss possible mechanisms and management. METHODS: We report on a 22-year-old male patient with a history of non-Hodgkin lymphoma, chronic renal failure peritoneal dialysis dependent, presented with a disabling pruritus around his left eye and forehead. Two months before, he was diagnosed with herpes zoster ophtalmicus. His itching intensity was 10/10 on a visual analog scale and he reported no pain. The neurologic examination showed a hyposensitivity to touch around his left eye. RESULTS: Our patient suffered of PHI who responded successfully to a combination of antihistamine and an antiepileptic agent. DISCUSSION: The mechanism of postherpetic neuralgia and PHI are not well understood and no single best treatment for postherpetic neuralgia and PHI is known. Clinical experience suggested that neuropathic itch may be more resistant to treatment than neuropathic pain. This immunocompromized patient with a severe disabling PHI responded to antihistaminic and anticonvulsant treatment.