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Chronic itch in African Americans: an unmet need

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Abstract

Chronic pruritus carries a significant burden of disease and is associated with a negative impact on quality of life. African Americans are disproportionately burdened by chronic pruritic disorders, including but not limited to atopic dermatitis, prurigo nodularis, inflammatory scalp dermatoses, pathologic scarring, and HIV-related dermatoses. Racial differences in skin structure and function may contribute to the pathogenesis of itch in African Americans. Itch perception and response to treatment in African Americans remain understudied and not well understood. As such, there is a large unmet need with regard to the knowledge and management of pruritus in African Americans. This review highlights notable differences in the epidemiology, pathophysiology, genetic predisposition, clinical presentation, and response to treatment for select pruritic skin conditions. By addressing itch as an unmet need in African Americans, we hope to improve patient outcomes and lessen disparities in dermatologic care.

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Abbreviations

αMSH:

Alpha-melanocyte stimulating hormone

AA:

African American

AD:

Atopic dermatitis

AKN:

Acne keloidalis nuchae

CCCA:

Central centrifugal cicatricial alopecia

COMT:

Catecholamine methyl-transferase

EASI:

Eczema Area and Severity Index

FLG:

Filaggrin

GPCR:

G-protein coupled receptor

hBD:

Haplotype of beta defensins

HF:

Hair follicle

HSF:

Hypertrophic scar formation

IL:

Interleukin

IL-4Rα:

Interleukin 4 receptor alpha

IRS:

Inner root hair sheath

MC1R:

Melanocortin-1-receptor

MRGPR:

Mas-related G protein-coupled receptor

NAMCS:

National ambulatory medical care survey

NK1:

Neurokinin 1

NGF:

Nerve growth factor

ORS:

Outer root hair sheath

PADI3:

Peptidyl arginine deiminase type III

PAR-2:

Protease activated receptor-2

PBP:

Post-burn pruritus

PGE2:

Prostaglandin E2

PN:

Prurigo nodularis

PPE:

Papular pruritic eruption

RNA:

Ribonucleic acid

SCORAD:

SCORing atopic dermatitis

SD:

Seborrheic dermatitis

TEWL:

Transepidermal water loss

Th:

Helper T cell

TrkA:

Tropomyosin receptor kinase-A

TRPV1:

Transient receptor vanilloid subtype-1

UVB:

Ultraviolet B

WHO:

World Health Organization

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Authors and Affiliations

  1. Dr. Phillip Frost Department of Dermatology and Miami Itch Center, University of Miami, Miami, FL, USA

    Giuseppe Ingrasci & Gil Yosipovitch

  2. The Kimberly and Eric J. Waldman Department of Dermatology at the Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Nour El-Kashlan & Andrew Alexis

Authors
  1. Giuseppe Ingrasci
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  2. Nour El-Kashlan
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  3. Andrew Alexis
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  4. Gil Yosipovitch
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All authors listed have contributed to the concept, design, analysis, writing and/or revision of the manuscript and have approved the final version of the paper. All authors certify that they have participated sufficiently in the work to take public responsibility for the content. All individuals who meet authorship criteria are included as authors of this paper. All authors consent to the publication of this work.

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Correspondence to Gil Yosipovitch.

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Conflict of interest

Giuseppe Ingrasci: None. Nour El-Kashlan: None. Andrew Alexis: serves as a principal investigator for clinical trials and received research grants from Menlo, Galderma, LEO, Novartis, Sanofi-Regeneron, Amgen. Has received honoraria for serving as a consultant/on the advisory board for Menlo, Galderma, LEO, Novartis, Sanofi-Regeneron, Dermavant. Gil Yosipovitch: is a consultant for: Pfizer, Galderma, Sanofi Regeneron, Kiniksa, Trevi, Eli Lilly, Novartis, GSK, Leo and Bellus, has received grant/research support from Leo Pharma, Pfizer, Novartis and Kiniksa, Sanofi, Regeneron.

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Ingrasci, G., El-Kashlan, N., Alexis, A. et al. Chronic itch in African Americans: an unmet need. Arch Dermatol Res 314, 405–415 (2022). https://doi.org/10.1007/s00403-021-02255-6

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