Neuropathic itch of the skin: practical aspects of diagnosis and treatment

Annotation. Itching is an interdisciplinary leading symptom of numerous diseases and presents a diagnostic and therapeutic challenge across various medical fields. Unlike acute itching, chronic pruritus is a symptom of different diseases and is often difficult to treat. The aim of this work is to analyze and systematize the main and current scientific sources regarding the prevalence, pathogenesis, diagnosis, and treatment of neuropathic skin itch. A review of scientific literature was conducted using the following sources: Scopus, Web of Science, Cochrane, PubMed, ResearchGate, Science Direct, Embase, and Google Scholar. Publications selected for this research were either published within the last seven years or were the most recent publications on the topic (regardless of publication date). The lifetime prevalence of chronic pruritus in the general population is 22%. Among the elderly, two-thirds experience itching. Itching may result from dermatological or non-dermatological conditions. Among these, neuropathic itch is an emerging area of interest and remains poorly studied. Neuropathic pruritus is defined as itch caused by damage to the somatosensory nervous system. It accounts for approximately 8–19% of chronic itchy dermatoses and encompasses a wide range of neurological disorders. Severe itching can lead to an itch-scratch cycle, a complex sensation similar to pain, with a reflexive response that causes stress and reduces quality of life. While neuropathic pain has been the subject of drug development, the same cannot be said for neuropathic itch, for which no approved therapy currently exists.