Work

Novel and existing therapeutic interventions in psychogenic pruritus

Year: 2026

Type: article

Abstract: Psychogenic pruritus (PP) is a chronic itch disorder associated with psychological conditions lacking any dermatological or systemic cause. Diagnosis relies on excluding other aetiologies and identifying psychological stressors. Treatments include dermatological and psychiatric interventions such as topical steroids, selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, antihistamines, antipsychotics and psychotherapy. However, efficacy remains inconsistent, necessitating a systematic review of current and emerging pharmacological options. This study reviews pharmacological treatments for PP published in the past decade, evaluating efficacy and therapeutic potential. A systematic literature search was conducted using PubMed, Embase and Google Scholar (November 2014 to November 2024) following the PRISMA guidelines (PROSPERO: 1000201). In total, 1034 articles were screened by two independent reviewers. Inclusion criteria focused on human studies evaluating pharmacological treatments for PP. Seven studies met the inclusion criteria. Levels of evidence were assessed using the Joanna Briggs Institute critical appraisal checklist. SSRIs, particularly escitalopram, showed symptom improvement in case reports. Naltrexone (an opioid antagonist) led to complete itch resolution in a patient refractory to SSRIs. Gabapentin reduced pruritus severity. A neurokinin-1 receptor (NK-1R) antagonist (serlopitant) demonstrated significant efficacy in a phase II trial. Biologics such as dupilumab showed promise in chronic pruritus. Targeted therapies, including SSRIs, naltrexone, opioid pathway modulators, NK-1R antagonists and biologics, show promise in the clinical management of PP, but further research through randomized controlled trials is necessary to establish their efficacy and optimize treatment strategies.

Source: Clinical and Experimental Dermatology

DOI: 10.1093/ced/llag005

Authors: Hira Ghani, Sasha Ghofrani, Nina Modanlo, Nithisha Cheedalla, Mohammad Jafferany

Institutions: Brown University, Philadelphia College of Osteopathic Medicine, University of California, Los Angeles, Central Michigan University

Language: English

Topic: Dermatology and Skin Diseases

Subfield: Dermatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,354