Background: Pruritus is defined as an “unpleasant sensation that elicits the desire or reflex to scratch”. It can occur without injury or disease, serves no apparent biological purpose and has no recognizable endpoint. It appears along with a number of skin and systemic diseases.

Aim: to determine the benefit of a novel topical anti-pruritic spray containing Camellia sinensis and Tambourissa spp leaf polyphenol extracts, and enoxolone in patients with atopic dermatitis (AD), psoriasis, chronic idiopathic urticaria (CIU) or senile pruritus.

Methodology: multicenter, prospective, observational, non-comparative study in 120 patients, 30 in each disease group. AD patients were to be aged between4monthsand 4years, psoriasis and CIU patients were to be of at least 18 years and senile pruritus patients of at least 65 years. At baseline and day 21, investigators assessed pruritus evolution using the 5-D pruritus scale, clinical efficacy and quality of life (QOL) through the Skindex-29 questionnaire in adults, the Infants' Dermatitis OOL Index and Family Dermatitis Index in children. Local tolerance was assessed.

Results: The spray quickly and significantly provided relief from pruritus. The QOL of patients and the impact on their families significantly improved. A large majority of the patients appreciated the spray for its efficacy and its cosmetic properties. One adverse effect was reported in the AD group after 14 days of application, leading to the patient’s discontinuation. Local tolerance was good.

Conclusion: The spray product significantly decreased pruritus severity, allowing an improvement in the daily life of patients with pruritic diseases.

Keywords: Pruritus, atopic dermatitis, psoriasis, chronic idiopathic urticaria, senile pruritus, itching, relief, spray.

1. Weisshaar E, Szepietowski JC, Darsow U, Misery L, Wallengren J, Mettang T, Gieler U, Lotti T, Lambert J, Maisel P, Streit M, Greaves MW, Carmichael AJ,Tschachler E, Ring J, Ständer S.European guideline on chronic pruritus. Acta Derm Venereol. 2012;92(5):563-81. doi: 10.2340/00015555-1400
2. Bautista DM, Wilson SR, Hoon MA. Why we scratch an itch: the molecules, cells and circuits of itch. Nat Neurosci. 2014;17(2):175-82. doi: 10.1038/nn.3619
3. Pereira MP, Stander S. Assessment of severity and burden of pruritus. Allergol Int. 2017;66(1):3-7. doi: 10.1016/j.alit.2016.08.009.
4. Kopyciok ME, Stander HF, Osada N, Steinke S, Stander S. Prevalence and Characteristics of Pruritus: A One-Week Cross-sectional Study in a German Derma-tology Practice. Acta Derm Venereol. 2016;96(1):50-5. doi: 10.2340/00015555-2166.
5. Ikoma A, Steinhoff M, Stander S, Yosipo-vitch G, Schmelz M. The neurob-iology of itch. Nat Rev Neurosci. 2006;7(7):535-47.
6. Halvorsen JA, Dalgard F, Thoresen M, Thoresen M, Bjertness E, Lien L. Itch and mental distress: a cross-sectional study among late adolescents. Acta Derm Vener-eol. 2009;89(1):39-44. doi: 10.2340/0001-5555-0554.
7. Dawn A, Papoiu AD, Chan YH, Rapp SR, Rassette N, Yosipovitch G. Itch characteristics in atopic dermatitis: results of a web-based questionnaire. Br J Dermatol. 2009;160(3):642-4. doi: 10.1111/j.1365-2133.2008.08941.x.
8. Roblin D, Wickramasinghe R, Yosipovitch G. Pruritus severity in patients with psoriasis is not correlated with psoriasis disease severity. J Am Acad Dermatol. 2014;70(2):390-1.
9. Al-Nuaimi Y, Sherratt MJ, Griffiths CE. Skin health in older age. Maturitas. 2014;79(3):256-64.doi: 10.1016/j.maturitas.2014.08.005.
10. Nakamura M, Toyoda M, Morohashi M. Pruritogenic mediators in psoriasis vulgaris: comparative evaluation of itch-associated cutaneous factors. Br J Dermatol. 2003;149(4):718-30.
11. Akiyama T, Carstens E. Neural processing of itch. Neuroscience. 2013;250:697-714.
12. Wilson SR, Thé L, Batia LM, Beattie K, Katibah GE, McClain SP, Pellegrino M, Estandian DM, Bautista DM.The epithelial cell-derived atopic dermatitis cytokine TSLP activates neurons to induce itch. Cell. 2013;155(2):285-95.doi: 10.1016/j.cell.2013.08.057.
13. Ziegler SF, Roan F, Bell BD, Stoklasek TA, Kitajima M, Han H. The biology of thymic stromal lymphopoietin (TSLP). Adv Pharmacol. 2013;66:129-55.doi: 10.1016/B978-0-12-404717-4.00004-4.
14. Schafer PH, Truzzi F, Parton A, Wu L, Kosek J, Zhang LH, Horan G, Saltari A, Quadri M, Lotti R, Marconi A, Pincelli C. Phosphodiesterase 4 in inflammatory diseases: Effects of apremilast in psoriatic blood and in dermal myofibroblasts through the PDE4/CD271 complex. Cell Signal. 2016;28(7):753-63.doi: 10.1016/j.cellsig.2016.01.007.
15. Soter NA. Treatment of chronic spontaneous urticaria. J Drugs Dermatol. 2015;14(4):332-4.
16. Blume-Peytavi U, Tan J, Tennstedt D, Boralevi F, Fabbrocini G, Torrelo A, Soares-Oliveira R, Haftek M, Rossi AB, Thouvenin MD, Mangold J, Galliano MF, Hernandez-Pigeon H, Aries MF, Rouvrais C, Bessou-Touya S, Duplan H, Castex-Rizzi N, Mengeaud V, Ferret PJ, Clouet E, Saint Aroman M, Carrasco C, Coutanceau C, Guiraud B, Boyal S, Herman A, Delga H, Biniek K, Dauskardt R.. Fragility of epidermis in newborns, children and adolescents. J Eur Acad Dermatol Venereol. 2016;30 Suppl 4:3-56.doi: 10.1111/jdv.13636.
17. Wolf R, Parish LC. Effect of soaps and detergents on epidermal barrier function. Clin Dermatol. 2012;30(3):297-300.doi: 10.1016/j.clindermatol.2011.08.021.
18. Humbert P, Dréno B, Krutmann J, Luger TA, Triller R, Meaume S, Seité S. Recommendations for managing cutaneous disorders associated with advancing age. Clin Interv Aging. 2016;11:141-8.doi: 10.2147/CIA.S96232. eCollection 2016.
19. Segond C, Chanteloube F, Loiseau A, Petit V, Theron E. Patent WO2010037545A1: Use of polyphenols to treat skin conditions. 2015, United States, Bayer Consumer Care AG (Basel, CH), 9114115. Available on http://www.freepatentso-nline.com/y2003/0175234.html.Last accessed: 30 January 2018.
20. Ruiz-Perez MV, Pino-Angeles A, Medina MA, Sanchez-Jimenez F, Moya-Garcia AA. Structural perspective on the direct inhibition mechanism of EGCG on mammalian histidine decarboxylase and DOPA decarboxylase. J Chem Inf Model. 2012;52(1):113-9.doi: 10.1021/ci200221z.
21. Akasaka Y, Yoshida T, Tsukahara M, Hatta A, Inoue H. Glycyrrhetinic acid prevents cutaneous scratching behavior in mice elicited by substance P or PAR-2 agonist. Eur J Pharmacol. 2011;670(1): 175-9.doi: 10.1016/j.ejphar.2011.08.043.
22. Imanishi N, Kawai H, Hayashi Y, Yatsunami K, Ichikawa A. Effects of glycyrrhizin and glycyrrhetinic acid on dexamethasone-induced changes in histamine synthesis of mouse mastocytoma P-815 cells and in histamine release from rat peritoneal mast cells. Biochem Pharmacol. 1989;38(15):2521-6.
23. Reich A, Heisig M, Phan NQ, Taneda K, Takamori K, Takeuchi S, Furue M, Blome C, Augustin M, Ständer S, Szepietowski JC.Visual analogue scale: evaluation of the instrument for the assessment of pruritus. Acta Derm Venereol.. 2012;92(5):497-501.doi: 10.2340/00015555-1265.
24. Elman S, Hynan LS, Gabriel V, Mayo MJ. The 5-D itch scale: a new measure of pruritus. Br J Dermatol. 2010;162(3):587-93.doi: 10.1111/j.1365-2133.2009.09586.x.
25. Lewis-Jones MS, Finlay AY, Dykes PJ. The Infants' Dermatitis Quality of Life Index. Br J Dermatol. 2001;144(1):104-10.
26. Janowski K, Steuden S, Bereza B. The Polish version of Skindex-29: psychometric properties of an instrument to measure quality of life in dermatology. Postepy Dermatol Alergol. 2014;31(1):12-20.doi: 10.5114/pdia.2014.40654.
27. Pandey M, Zhang JH, Mishra SK, Adikaram PR, Harris B, Kahler JF, Loshakov A, Sholevar R, Genis A, Kittock C, Kabat J, Ganesan S, Neubig RR, Hoon MA, Simonds WF. A central role for R7bp in the regulation of itch sensation. Pain. 2017;158(5):931-44.doi: 10.1097/j.pain.0000000000000860.
28. Soeberdt M, Molenveld P, Storcken RP, Bouzanne des Mazery R, Sterk GJ, Autar R, Bolster MG, Wagner C, Aerts SN, van Holst FR, Wegert A, Tangherlini G, Frehland B, Schepmann D, Metze D, Lotts T, Knie U, Lin KY, Huang TY, Lai CC,Ständer S, Wünsch B, Abels C.Design and Synthesis of Enantiomerically Pure Decahydroquinoxalines as Potent and Selective kappa-Opioid Receptor Agonists with Anti-Inflammatory Activity in Vivo. J Med Chem. 2017;60(6):2526-51.doi: 10.1021/acs.jmedchem.6b01868.
29. Mettang T, Stander S, Kremer AE. [Treatment of chronic itch in systemic disease. Current standards]. Internist (Berl). 2015;56(12):1369-78.
30. Onuki Y, Machida Y, Yokawa T, Seike C, Sakurai S, Takayama K. Magnetic resonance imaging study on the physical stability of menthol and diphenhydramine cream for the treatment of chronic kidney disease-associated pruritus. Chem Pharm Bull (Tokyo). 2015;63(6):457-62.doi: 10.1248/cpb.c15-00192.
31. Kulczycka-Siennicka L, Cynkier A, Waszczykowska E, Wozniacka A, Zebrowska A. The Role of Intereukin-31 in Pathogenesis of Itch and Its Intensity in a Course of Bullous Pemphigoid and Dermatitis Herpetiformis. Biomed Res Int. 2017;2017:5965492.doi: 10.1155/2017/5965492.
32. Paller AS, Tom WL, Lebwohl MG, Blumenthal RL, Boguniewicz M, Call RS, Eichenfield LF, Forsha DW, Rees WC, Simpson EL, Spellman MC, Stein Gold LF,Zaenglein AL, Hughes MH, Zane LT, Hebert AA. Efficacy and safety of crisaborole ointment, a novel, nonsteroidal phosphodiesterase 4 (PDE4) inhibitor for the topical treatment of atopic dermatitis (AD) in children and adults. J Am Acad Dermatol. 2016;75(3):494-503.e6.doi: 10.1016/j.jaad.2016.05.046.

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