Vijay Kodumudi1, David Lam2, Kanishka Rajput3. 1. University of Connecticut School of Medicine, 263 Farmington Ave., Farmington, CT, 06030, USA. 2. Department of Anesthesiology and Pain Medicine, Yale University School of Medicine, 333 Cedar Street TMP3, New Haven, CT, 06510, USA. 3. Department of Anesthesiology and Pain Medicine, Yale University School of Medicine, 333 Cedar Street TMP3, New Haven, CT, 06510, USA. kanishkarajput@yale.edu.
Abstract
PURPOSE OF REVIEW: Pain management in dermatologic conditions can be complicated by the primary disease burden and associated decreased quality of life, disability, and psychosocial issues. This review focuses on pain management strategies in some of the more painful dermatologic conditions. RECENT FINDINGS: Pain management in painful dermatologic conditions such as pyoderma gangrenosum, postherpetic neuralgia, lower limb ulcers, and hidradenitis suppurativa revolves around treatment of the underlying disease process. Topical agents such as topical steroids and systemic immunosuppressants with over-the-counter analgesics usually suffice in mild to moderate pain. Severe pain may need neuropathic agents and referral to interventional pain physicians for consideration of advanced techniques such as epidural steroid injections and sympathetic nerve blocks. Part of the treatment process is for dermatologists to establish patient expectations and to treat pain within their scope of practice. More research is needed towards pain control in painful dermatologic conditions with elucidation of treatment algorithms unique to each condition.
PURPOSE OF REVIEW: Pain management in dermatologic conditions can be complicated by the primary disease burden and associated decreased quality of life, disability, and psychosocial issues. This review focuses on pain management strategies in some of the more painful dermatologic conditions. RECENT FINDINGS:Pain management in painful dermatologic conditions such as pyoderma gangrenosum, postherpetic neuralgia, lower limb ulcers, and hidradenitis suppurativa revolves around treatment of the underlying disease process. Topical agents such as topical steroids and systemic immunosuppressants with over-the-counter analgesics usually suffice in mild to moderate pain. Severe pain may need neuropathic agents and referral to interventional pain physicians for consideration of advanced techniques such as epidural steroid injections and sympathetic nerve blocks. Part of the treatment process is for dermatologists to establish patient expectations and to treat pain within their scope of practice. More research is needed towards pain control in painful dermatologic conditions with elucidation of treatment algorithms unique to each condition.
Authors: Stephen G Waxman; Ingemar S J Merkies; Monique M Gerrits; Sulayman D Dib-Hajj; Giuseppe Lauria; James J Cox; John N Wood; C Geoffrey Woods; Joost P H Drenth; Catharina G Faber Journal: Lancet Neurol Date: 2014-11 Impact factor: 44.182
Authors: Nanna B Finnerup; Nadine Attal; Simon Haroutounian; Ewan McNicol; Ralf Baron; Robert H Dworkin; Ian Gilron; Maija Haanpää; Per Hansson; Troels S Jensen; Peter R Kamerman; Karen Lund; Andrew Moore; Srinivasa N Raja; Andrew S C Rice; Michael Rowbotham; Emily Sena; Philip Siddall; Blair H Smith; Mark Wallace Journal: Lancet Neurol Date: 2015-01-07 Impact factor: 44.182