PMID- 32891774
OWN - NLM
STAT- MEDLINE
DCOM- 20210531
LR  - 20210531
IS  - 1097-6787 (Electronic)
IS  - 0190-9622 (Linking)
VI  - 84
IP  - 1
DP  - 2021 Jan
TI  - Substance use disorders and chronic itch.
PG  - 148-155
LID - S0190-9622(20)32545-7 [pii]
LID - 10.1016/j.jaad.2020.08.117 [doi]
AB  - Chronic pruritus is one dermatologic manifestation of an underlying substance use 
      disorder. Recent literature has uncovered similarities between the general 
      neurologic mechanisms of addiction and chronic itch, largely involving activation 
      of the dopaminergic reward circuits within the brain and imbalances between mu 
      and kappa opioid receptor activation. It is likely that the use of specific 
      drugs, like central nervous system stimulants and opioids, results in further 
      activation and imbalances within these pathways, perpetuating both addiction and 
      pruritus simultaneously. Opioid users often present to dermatology clinics with a 
      generalized pruritus, whereas individuals using central nervous system stimulants 
      like cocaine and methylenedioxymethamphetamine (MDMA), as well as legally 
      prescribed drugs like treatments for attention deficit hyperactivity disorder, 
      frequently complain of crawling, delusional infestation-like sensations 
      underneath the skin. Because of these overlapping mechanisms and similar clinical 
      presentations to many other chronically itchy conditions, it is necessary for 
      dermatologists to consider and investigate an underlying substance use disorder 
      to effectively treat these patients.
CI  - Copyright (c) 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. 
      All rights reserved.
FAU - Lipman, Zoe M
AU  - Lipman ZM
AD  - Dr Phillip Frost Department of Dermatology and Miami Itch Center, University of 
      Miami, Miami, Florida.
FAU - Yosipovitch, Gil
AU  - Yosipovitch G
AD  - Dr Phillip Frost Department of Dermatology and Miami Itch Center, University of 
      Miami, Miami, Florida. Electronic address: yosipog@gmail.com.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20200903
PL  - United States
TA  - J Am Acad Dermatol
JT  - Journal of the American Academy of Dermatology
JID - 7907132
SB  - IM
MH  - Amphetamine-Related Disorders/*complications/physiopathology
MH  - Chronic Disease
MH  - Cocaine-Related Disorders/*complications/physiopathology
MH  - Humans
MH  - Neural Pathways
MH  - Opioid-Related Disorders/*complications/physiopathology
MH  - Pruritus/*chemically induced/physiopathology
OTO - NOTNLM
OT  - CNS stimulants
OT  - addiction
OT  - amphetamines
OT  - cocaine
OT  - delusions of infestation
OT  - itch
OT  - opioids
OT  - pruritus
OT  - substance use
EDAT- 2020/09/07 06:00
MHDA- 2021/06/01 06:00
CRDT- 2020/09/06 20:25
PHST- 2020/07/07 00:00 [received]
PHST- 2020/08/26 00:00 [revised]
PHST- 2020/08/30 00:00 [accepted]
PHST- 2020/09/07 06:00 [pubmed]
PHST- 2021/06/01 06:00 [medline]
PHST- 2020/09/06 20:25 [entrez]
AID - S0190-9622(20)32545-7 [pii]
AID - 10.1016/j.jaad.2020.08.117 [doi]
PST - ppublish
SO  - J Am Acad Dermatol. 2021 Jan;84(1):148-155. doi: 10.1016/j.jaad.2020.08.117. Epub 
      2020 Sep 3.