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Abstract：
Pruritus is a common and often times difficult to treat symptom in many dermatologic and systemic diseases. For pruritus with an inflammatory or autoimmune origin, therapies such as topical corticosteroids and antihistamines are often initiated. However, in the case that these and additional systemic therapies are ineffective, thalidomide, an immunomodulator and neuromodulator, may be a useful alternative treatment. Considerable relief of chronic pruritus has been demonstrated with thalidomide in case reports, case series, and controlled trials. Double-blind controlled studies demonstrated thalidomide\'s efficacy as an antipruritic agent in patients with uremic pruritus, primary biliary cirrhosis, and prurigo nodularis. In case reports, case series, and open-label trials, thalidomide significantly reduced pruritus associated with conditions such as actinic prurigo and paraneoplastic pruritus. Because of variations in study design and evaluation of antipruritic effect, it is difficult to fully understand thalidomide\'s role based on the evidence described to date in the medical literature. In this review, we provide an overview of the reported findings and evaluate thalidomide\'s utility in managing refractory pruritus in the context of its adverse risk profile. We propose that thalidomide can be an alternative or combination antipruritic treatment for patients who do not obtain enough relief from conservative therapy.
摘要：
瘙痒是许多皮肤病和全身性疾病中常见且经常难以治疗的症状。对于炎性或自身免疫性瘙痒，通常会开始局部使用皮质类固醇和抗组胺药等疗法。然而,在这些和其他全身疗法无效的情况下，沙利度胺,免疫调节剂和神经调质，可能是一种有用的替代疗法。在病例报告中，沙利度胺可显著缓解慢性瘙痒。案例系列,和对照试验。双盲对照研究证明沙利度胺作为止痒剂在尿毒症瘙痒患者中的疗效。原发性胆汁性肝硬化,和结节性痒疹.在案例报告中，案例系列,和开放标签试验，沙利度胺可显着减少与光化性瘙痒和副肿瘤性瘙痒等相关的瘙痒。由于研究设计和止痒效果评估的差异，根据迄今为止医学文献中描述的证据，很难完全理解沙利度胺的作用。在这次审查中,我们对报告的研究结果进行了概述,并评估了沙利度胺在治疗难治性瘙痒不良风险背景下的效用.我们建议沙利度胺可以作为保守治疗未获得足够缓解的患者的替代或联合止痒治疗。
