Itching as the onset of pain (part 3)


  • Valerii Kushnir National Pirogov Memorial Medical University, Vinnytsia
  • Svitlana Dmytrenko National Pirogov Memorial Medical University, Vinnytsia
  • Oleksandr Katilov National Pirogov Memorial Medical University, Vinnytsia
  • Natalia Kushnir Zabolotniy Vinnitsa State Medical College



pain, itching, comorbidity, quality of life


Itchy skin is an extremely unpleasant symptom that can provoke insomnia, depression, irritability, loss of appetite. There are several theories of itching. According to one of them, itching is a modified pain caused by a slight irritation of the nerve endings in the skin. According to the second, itching is an independent symptom, in the formation of which nervous, humoral and vascular mechanisms are involved. Other theories consider itching as a reaction of the autonomic nervous system or a hereditary pathological condition. According to recent studies, itchy skin is characterized by the absence of a universal peripheral mediator of itching. The trigger for itching is the action of pruritogen – a mechanical, chemical, thermal or electrical stimulant directly or indirectly through mediators.

Free ends of type A delta fibers and type C fibers play a crucial role in itching and pain. If this was previously confirmed only by clinical observations, now there are neurophysiological studies that support the theory that itching and pain fibers are one with different activity thresholds. Today, it is unacceptable that there are separate specific receptors for different sensations. It is now assumed that there are mixed receptors for heat, cold, pain, itching and touch [95].

Systematic use of substances included in the list of drugs and manifested by mental and physical dependence on them – drug addiction, one of the diseases of society. But drug addiction is sometimes forced, according to medical indications, in cases of palliative conditions. Depending on the stage of the person after taking the drug or in the interval between drug use, one of the signs of use may be severe itching of the skin.

And after excluding both the main diseases that cause itching and other secondary causes of itching, it can be assumed that a person has idiopathic generalized pruritus (itching) of unknown origin (GPOU).

The itching of the elderly, which is quite common in the elderly, as a manifestation of concomitant, often combined, somatic pathology, but may also be due to physiological changes, both on the skin and on the physiological aging of nerve endings.


Download data is not yet available.


Raksha Mp, Marfatia Y. Clinical study of cutaneous drug eruptions in 200 patients. Indian Journal of Dermatology, Venereology and Leprology [Internet]. Medknow; 2008;74(1):80. Available from:

Reich A, Ständer S, Szepietowski J. Drug-induced Pruritus: A Review. Acta Dermato Venereologica [Internet]. Acta Dermato-Venereologica; 2009;89(3):236–44. Available from:

Niklasson O, Boman K, Stenberg B. The prevalence and characteristics of pruritus in patients with heart failure. British Journal of Dermatology [Internet]. Wiley; 2015 May 12;172(6):1541–6. Available from:

Miller JL, Hagemann TM. Use of pure opioid antagonists for management of opioid-induced pruritus. American Journal of Health-System Pharmacy [Internet]. Oxford University Press (OUP); 2011 Aug 1;68(15):1419–25. Available from:

Bart G. Maintenance medication for opiate addiction: the foundation of recovery. J Addict Dis 2012; 31: 207– 25.

Kjellberg F, Tramèr MR. Pharmacological control of opioid-induced pruritus: a quantitative systematic review of randomized trials. European Journal of Anaesthesiology [Internet]. Ovid Technologies (Wolters Kluwer Health); 2001 Jun;18(6):346–57. Available from:

Yuan C-S, Foss JF, O’Connor M, Osinski J, Roizen MF, Moss J. Efficacy of orally administered methylnaltrexone in decreasing subjective effects after intravenous morphine. Drug and Alcohol Dependence [Internet]. Elsevier BV; 1998 Oct;52(2):161–5. Available from:

Wu Z, Kong M, Wang N, Finlayson RJ, De Tran QH. Intravenous butorphanol administration reduces intrathecal morphine-induced pruritus after cesarean delivery: a randomized, double-blind, placebo-controlled study. Journal of Anesthesia [Internet]. Springer Science and Business Media LLC; 2012 Jun 7;26(5):752–7. Available from:

George RB, Allen TK, Habib AS. Serotonin Receptor Antagonists for the Prevention and Treatment of Pruritus, Nausea, and Vomiting in Women Undergoing Cesarean Delivery with Intrathecal Morphine: A Systematic Review and Meta-Analysis. Anesthesia & Analgesia [Internet]. Ovid Technologies (Wolters Kluwer Health); 2009 Jul;109(1):174–82. Available from:

Brião FF da C, Horta ML, Horta BL, de Barros GAM, Behrensdorf AP, Severo I, et al. Comparison of droperidol and ondansetron prophylactic effect on subarachnoid morphine-induced pruritus. Brazilian Journal of Anesthesiology (English Edition) [Internet]. Elsevier BV; 2015 Jul;65(4):244–8. Available from:

Colbert S, O’hanlon DM, Galvin S, Chambers F, Moriarty DC. The effect of rectal diclofenac on pruritus in patients receiving intrathecal morphine. Anaesthesia [Internet]. Wiley; 1999 Oct;54(10):948–52. Available from:

Sheen MJ, Ho ST, Lee CH et al. Prophylactic mirtazapine reduces intrathecal morphine‐induced pruritus. Br J Anaesth 2008; 101: 711– 15.

Sheen MJ, Ho S-T, Lee C-H, Tsung Y-C, Chang F-L. Preoperative Gabapentin Prevents Intrathecal Morphine-Induced Pruritus After Orthopedic Surgery. Anesthesia & Analgesia [Internet]. Ovid Technologies (Wolters Kluwer Health); 2008 Jun;106(6):1868–72. Available from:

Adebayo RA, Sofowora GG, Onayemi O, Udoh SJ, Ajayi AA. Chloroquine‐induced pruritus in malaria fever: contribution of malaria parasitaemia and the effects of prednisolone, niacin, and their combination, compared with antihistamine. British Journal of Clinical Pharmacology [Internet]. Wiley; 1997 Aug;44(2):157–61. Available from:

Ajayi AA, Kolawole BA, Udoh SJ. Endogenous opioids, µ-opiate receptors and chloroquine-induced pruritus: A double-blind comparison of naltrexone and promethazine in patients with malaria fever who have an established history of generalized chloroquine-induced itching. International Journal of Dermatology [Internet]. Wiley; 2004 Dec;43(12):972–7. Available from:

Spencer HC, Poulter NR, Lury JD, Poulter CJ. Chloroquine-associated pruritus in a European. BMJ [Internet]. BMJ; 1982 Dec 11;285(6356):1703–4. Available from:

Onyeji CO, Ogunbona FA. Pharmacokinetic aspects of chloroquine-induced pruritus: influence of dose and evidence for varied extent of metabolism of the drug. European Journal of Pharmaceutical Sciences [Internet]. Elsevier BV; 2001 May;13(2):195–201. Available from:

Aghahowa S, Obianwu H, Isah A, Arhewoh I. Chloroquine-induced Pruritus. Indian Journal of Pharmaceutical Sciences [Internet]. OMICS Publishing Group; 2010;72(3):283. Available from:

Asawalam B, Osifo NG, Haller L. Drugs against chloroquine antimalarial itch. Journal of the European Academy of Dermatology and Venereology [Internet]. Wiley; 2006 Jul 28;2(3):193–9. Available from:

El Abd O, Pimentel DC, Amadera JED. Generalized Pruritus as an Unusual Side Effect After Epidural Injection With Dexamethasone. PM&R [Internet]. Wiley; 2014 Oct 5;7(2):206–9. Available from:

Szczepanowska J, Reich A, Szepietowski JC. Emollients improve treatment results with topical corticosteroids in childhood atopic dermatitis: a randomized comparative study. Pediatric Allergy and Immunology [Internet]. Wiley; 2008 Jan 20;19(7):614–8. Available from:

Eschler DC, Klein PA. An evidence‐based review of the efficacy of topical antihistamines in the relief of pruritus. J Drugs Dermatol 2010; 9: 992–7.

Bonnel RA, La Grenade L, Karwoski CB, Beitz JG. Allergic contact dermatitis from topical doxepin: Food and Drug Administration’s postmarketing surveillance experience. Journal of the American Academy of Dermatology [Internet]. Elsevier BV; 2003 Feb;48(2):294–6. Available from:

Smith EB, King CA, Baker MD. Crotamiton Lotion in Pruritus. International Journal of Dermatology [Internet]. Wiley; 1984 Dec;23(10):684–5. Available from:

Yosipovitch G, Szolar C, Hui XY, Maibach H. Effect of topically applied menthol on thermal, pain and itch sensations and biophysical properties of the skin. Archives of Dermatological Research [Internet]. Springer Science and Business Media LLC; 1996 May;288(5-6):245–8. Available from:

Gooding SMD, Canter PH, Coelho HF, Boddy K, Ernst E. Systematic review of topical capsaicin in the treatment of pruritus. International Journal of Dermatology [Internet]. Wiley; 2010 Jul 19;49(8):858–65. Available from:

Gal-Oz A, Rogowski O, Swartzon M, Kivity S. Ethyl Chloride as an Antipruritic Agent: A Double-Blind Placebo-Controlled Prospective Study. Dermatology [Internet]. S. Karger AG; 2010;221(4):373–7. Available from:

Gal-Oz A, Kivity S, Shacham Y, Fiszer E, Rogowsky O, Chernin G. Prevention of pruritus with ethyl-chloride in skin prick test: a double-blind placebo-controlled prospective study. Allergy, Asthma & Clinical Immunology [Internet]. Springer Science and Business Media LLC; 2015 Sep 4;11(1). Available from:

Bernstein JE, Whitney DH, Soltani K. Inhibition of histamine-induced pruritus by topical tricyclic antidepressants. Journal of the American Academy of Dermatology [Internet]. Elsevier BV; 1981 Nov;5(5):582–5. Available from:

Yosipovitch G, Szolar C, Hui XY, Maibach H. High-potency topical corticosteroid rapidly decreases histamine-induced itch but not thermal sensation and pain in human beings. Journal of the American Academy of Dermatology [Internet]. Elsevier BV; 1996 Jul;35(1):118–20. Available from:

Buddenkotte J, Steinhoff M. Pathophysiology and therapy of pruritus in allergic and atopic diseases. Allergy [Internet]. Wiley; 2010 Apr 7;65(7):805–21. Available from:

Davies MG, Marks R, Horton RJ, Storari FE. The efficacy of histamine antagonists as antipruritics in experimentally induced pruritus. Archives of Dermatological Research [Internet]. Springer Science and Business Media LLC; 1979;266(2):117–20. Available from:

Arnold AJ, Simpson JG, Jones HE et al. Suppression of histamine‐induced pruritus by hydroxyzine and various neuroleptics. J Am Acad Dermatol 1979; 1: 509–12.

Bartuzi Z, Brzoza Z, Czarnecka-Operacz M, Kruszewski J, Maj J, Samochocki Z, et al. Komentarz Stanowisko zespołu ekspertów Polskiego Towarzystwa Alergologicznego i Polskiego Towarzystwa Dermatologicznego w sprawie wytycznych postępowania w pokrzywce* Komentarz do: Zuberbier T, Aberer W, Asero R et al. The EAACI/GA2 LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update. Allergy 2014; 69: 868-887. Dermatology Review [Internet]. Termedia Sp. z.o.o.; 2015;2:180–2. Available from:

Gokdemir G, Doruk T. Treatment of generalized pruritus: comparison of narrowband ultraviolet-B with oral cetirizine. Journal of the European Academy of Dermatology and Venereology [Internet]. Wiley; 2010 Dec 13;25(12):1484–5. Available from:

Ständer S, Böckenholt B, Schürmeyer-Horst F, Weishaupt C, Heuft G, Schneider T. Treatment of Chronic Pruritus with the Selective Serotonin Re-uptake Inhibitors Paroxetine and Fluvoxamine: Results of an Open-labelled, Two-arm Proof-of-concept Study. Acta Dermato Venereologica [Internet]. Acta Dermato-Venereologica; 2009;89(1):45–51. Available from:

Hundley JL, Yosipovitch G. Mirtazapine for reducing nocturnal itch in patients with chronic pruritus: a pilot study. Journal of the American Academy of Dermatology [Internet]. Elsevier BV; 2004 Jun;50(6):889–91. Available from:

METZE D, REIMANN S, LUGER TA. Effective Treatment of Pruritus with Naltrexone, an Orally Active Opiate Antagonist. Annals of the New York Academy of Sciences [Internet]. Wiley; 2006 Feb 6;885(1):430–2. Available from:

Dawn AG, Yosipovitch G. Butorphanol for treatment of intractable pruritus. J Am Acad Dermatol 2006; 54: 527–31.

Yesudian PD, Wilson NJE. Efficacy of Gabapentin in the Management of Pruritus of Unknown Origin. Archives of Dermatology [Internet]. American Medical Association (AMA); 2005 Dec 1;141(12). Available from:

Ruiz‐Villaverde R, Sánchez‐Cano D. [Idiopathic senile pruritus: therapeutic response to gabapentin]. Rev Esp Geriatr Gerontol 2009; 44: 355–6 (in Spanish).

Ehrchen J, Ständer S. Pregabalin in the treatment of chronic pruritus. J Am Acad Dermatol 2008; 58: S36–7.

Schwörer H, Ramadori G. Treatment of pruritus: a new indication for serotonin type 3 receptor antagonists. The Clinical Investigator [Internet]. Springer Science and Business Media LLC; 1993 Aug;71(8). Available from:

Maley A, Swerlick RA. Azathioprine treatment of intractable pruritus: A retrospective review. Journal of the American Academy of Dermatology [Internet]. Elsevier BV; 2015 Sep;73(3):439–43. Available from:

Ständer S, Siepmann D, Herrgott I, Sunderkötter C, Luger TA. Targeting the Neurokinin Receptor 1 with Aprepitant: A Novel Antipruritic Strategy. Soyer HP, editor. PLoS ONE [Internet]. Public Library of Science (PLoS); 2010 Jun 4;5(6):e10968. Available from:

Tan JKL, Haberman HF, Coldman AJ. Identifying effective treatments for uremic pruritus. Journal of the American Academy of Dermatology [Internet]. Elsevier BV; 1991 Nov;25(5):811–8. Available from:

GILCHREST BA. Ultraviolet Phototherapy of Uremic Pruritus. Annals of Internal Medicine [Internet]. American College of Physicians; 1979 Jul 1;91(1):17. Available from:

Seckin D, Demircay Z, Akin O. Generalized pruritus treated with narrowband UVB. International Journal of Dermatology [Internet]. Wiley; 2007 Apr;46(4):367–70. Available from:

Ada S, Seçkin D, Budakoğlu İ, Özdemir FN. Treatment of uremic pruritus with narrowband ultraviolet B phototherapy: An open pilot study. Journal of the American Academy of Dermatology [Internet]. Elsevier BV; 2005 Jul;53(1):149–51. Available from:

Hsu ML, Yang CC. Uraemic pruritus responsive to broadband ultraviolet (UV) B therapy does not readily respond to narrowband UVB therapy. British Journal of Dermatology [Internet]. Wiley; 2003 Oct;149(4):888–9. Available from:

Ko M-J, Yang J-Y, Wu H-Y, Hu F-C, Chen S-I, Tsai P-J, et al. Narrowband ultraviolet B phototherapy for patients with refractory uraemic pruritus: a randomized controlled trial. British Journal of Dermatology [Internet]. Wiley; 2011 Aug 28;165(3):633–9. Available from:

Steinman HK, Greaves MW. Aquagenic pruritus. J Am Acad Dermatol 1985; 13: 91–6.

Greaves M, Handfield‐Jones S. Aquagenic pruritus, pharmacological findings and treatment. Eur J Dermatol 1992; 2: 482–4.

Baldo A, Sammarco E, Plaitano R, Martinelli V, Monfrecola G. Narrowband (TL-01) ultraviolet B phototherapy for pruritus in polycythaemia vera. British Journal of Dermatology [Internet]. Wiley; 2002 Nov;147(5):979–81. Available from:

Madkan VK, Bandow GD, Koo JYM. Resolution of pruritus secondary to polycythemia vera in a patient treated with narrow‐band ultraviolet B phototherapy. Journal of Dermatological Treatment [Internet]. Informa UK Limited; 2005 Feb;16(1):56–8. Available from:

MENAGE HDP, NORRIS PG, HAWK JLM, GREAVES MW. The efficacy of psoralen photochemotherapy in the treatment of aquagenic pruritus. British Journal of Dermatology [Internet]. Wiley; 1993 Aug;129(2):163–5. Available from:

Swerlick RA. Photochemotherapy treatment of pruritus associated with polycythemia vera. J Am Acad Dermatol 1985; 13: 675–7.

Holme SA, Anstey AV. Aquagenic pruritus responding to intermittent photochemotherapy. Clinical and Experimental Dermatology [Internet]. Wiley; 2001 Jan;26(1):40–1. Available from:

Smith RA, Ross JS, Staughtion RCD. Bath PUVA as a treatment for aquagenic pruritus. British Journal of Dermatology [Internet]. Wiley; 2006 Jul 29;131(4):584–584. Available from:

Goodkin R, Bernhard JD. Repeated PUVA treatment of aquagenic pruritus. Clinical and Experimental Dermatology [Internet]. Wiley; 2002 Mar;27(2):164–5. Available from:

Xifra A, Carrascosa JM, Ferrandiz C. Narrow-band ultraviolet B in aquagenic pruritus. British Journal of Dermatology [Internet]. Wiley; 2005 Dec;153(6):1233–4. Available from:

Ingber S, Cohen PD. Successful Treatment of Refractory Aquagenic Pruritus with Naltrexone. Journal of Cutaneous Medicine and Surgery [Internet]. SAGE Publications; 2005 Oct;9(5):215–6. Available from:

Koh MJA, Chong WS. Aquagenic pruritus responding to combined ultraviolet A/narrowband ultraviolet B therapy. Photodermatology, Photoimmunology & Photomedicine [Internet]. Wiley; 2009 Jun;25(3):169–70. Available from:

Hanid MA, Levi AJ. PHOTOTHERAPY FOR PRURITUS IN PRIMARY BILIARY CIRRHOSIS. The Lancet [Internet]. Elsevier BV; 1980 Sep;316(8193):530. Available from:

Perlstein SM. Treatment of Primary Biliary Cirrhosis. Archives of Dermatology [Internet]. American Medical Association (AMA); 1974 Jul 1;110(1):132. Available from:

Decock S, Roelandts R, Steenbergen WV, Laleman W, Cassiman D, Verslype C, et al. Cholestasis-induced pruritus treated with ultraviolet B phototherapy: An observational case series study. Journal of Hepatology [Internet]. Elsevier BV; 2012 Sep;57(3):637–41. Available from:

CERIO R, MURPHY GM, SLADEN GE, MACDONALD DM. A combination of phototherapy and cholestyramine for the relief of pruritus in primary biliary cirrhosis. British Journal of Dermatology [Internet]. Wiley; 1987 Feb;116(2):265–7. Available from:

Person JR. Ultraviolet A (UV-A) and Cholestatic Pruritus. Archives of Dermatology [Internet]. American Medical Association (AMA); 1981 Nov 1;117(11):684. Available from:

Breuer-McHam J, Marshall G, Adu-Oppong A, Goller M, Mays S, Berger T, et al. Alterations in HIV expression in AIDS patients with psoriasis or pruritus treated with phototherapy. Journal of the American Academy of Dermatology [Internet]. Elsevier BV; 1999 Jan;40(1):48–60. Available from:

Gorin I, Lessana-Leibowitch M, Fortier P, Leibowitch J, Escande J-P. Successful treatment of the pruritus of human immunodeficiency virus infection and acquired immunodeficiency syndrome with psoralens plus ultraviolet A therapy. Journal of the American Academy of Dermatology [Internet]. Elsevier BV; 1989 Mar;20(3):511–3. Available from:

Özden MG, Aydın F, Şentürk N, Bek Y, Cantürk T, Turanlı AY. Narrow-band ultraviolet B as a potential alternative treatment for resistant psychogenic excoriation: an open-label study. Photodermatology, Photoimmunology & Photomedicine [Internet]. Wiley; 2010 Jun;26(3):162–4. Available from:

Xiao F. Cutaneous pruritus treated by Chinese medicine. J Chin Med 2002; 69: 30–2

Ma K-W. Acupuncture: Its Place in the History of Chinese Medicine. Acupuncture in Medicine [Internet]. SAGE Publications; 2000 Dec;18(2):88–99. Available from:

PFAB F, HAMMES M, BACKER M, HUSSMARP J, ATHANASIADIS G, TOLLE T, et al. Preventive effect of acupuncture on histamine-induced itch: A blinded, randomized, placebo-controlled, crossover trial. Journal of Allergy and Clinical Immunology [Internet]. Elsevier BV; 2005 Dec;116(6):1386–8. Available from:

Che-yi C, Wen CY, Min-Tsung K, Chiu-Ching H. Acupuncture in haemodialysis patients at the Quchi (LI11) acupoint for refractory uraemic pruritus. Nephrology Dialysis Transplantation [Internet]. Oxford University Press (OUP); 2005 Jun 28;20(9):1912–5. Available from:

Kim KH, Lee MS, Choi S-M, Ernst E. Acupuncture for Treating Uremic Pruritus in Patients with End-Stage Renal Disease: A Systematic Review. Journal of Pain and Symptom Management [Internet]. Elsevier BV; 2010 Jul;40(1):117–25. Available from:

Jiang Y, Jiang W, Jiang L, Lin G, Yang H, Tan Y, et al. Clinical efficacy of acupuncture on the morphine-related side effects in patients undergoing spinal-epidural anesthesia and analgesia. Chinese Journal of Integrative Medicine [Internet]. Springer Science and Business Media LLC; 2010 Feb;16(1):71–4. Available from:

Yan C, Yao W, Bao Y, Shi X, Yu H, Yin P, et al. Effect of Auricular Acupressure on Uremic Pruritus in Patients Receiving Hemodialysis Treatment: A Randomized Controlled Trial. Evidence-Based Complementary and Alternative Medicine [Internet]. Hindawi Limited; 2015;2015:1–8. Available from:

Cürcani M, Tan M. The effect of aromatherapy on haemodialysis patients’ pruritus. Journal of Clinical Nursing [Internet]. Wiley; 2014 Mar 20;23(23-24):3356–65. Available from:

Ro YJ, Ha HC, Kim CG et al. The effects of aromatherapy on pruritus in patients undergoing hemodialysis. Dermatol Nurs 2002; 14: 231– 4, 237–8, 256.

Aramwit P, Keongamaroon O, Siritientong T, Bang N, Supasyndh O. Sericin cream reduces pruritus in hemodialysis patients: a randomized, double-blind, placebo-controlled experimental study. BMC Nephrology [Internet]. Springer Science and Business Media LLC; 2012 Sep 24;13(1). Available from:

Pakfetrat M, Basiri F, Malekmakan L, Roozbeh J. Effects of turmeric on uremic pruritus in end stage renal disease patients: a double-blind randomized clinical trial. Journal of Nephrology [Internet]. Springer Science and Business Media LLC; 2014 Jan 31;27(2):203–7. Available from:

Ghanei E, Zeinali J, Borghei M et al. Efficacy of omega‐3 fatty acids supplementation in treatment of uremic pruritus in hemodialysis patients: a double‐blind randomized controlled trial. Iran Red Crescent Med J 2012; 14: 515–22.

Mohammad Ali BM, Hegab DS, El Saadany HM. Use of transcutaneous electrical nerve stimulation for chronic pruritus. Dermatologic Therapy [Internet]. Wiley; 2015 May 14;28(4):210–5. Available from:

Kantor GR, Lookingbill DP. Generalized pruritus and systemic disease. J Am Acad Dermatol 1983; 9: 375–82.

National Institute for Health and Care Excellence. Clinical knowledge summaries. Itch – widespread. Available at:!backgroundsub (last accessed 19 October 2017).

National Health Service Scotland. Dermatology patient pathways. Available at: (last accessed 19 October 2017).

Ward JR, Bernhard JD. Willan's itch and other causes of pruritus in the elderly. Int J Dermatol 2005; 44: 267– 73.

Grundmann SA, Ständer S. Evaluation of chronic pruritus in older patients. Aging Health [Internet]. Future Medicine Ltd; 2010 Feb;6(1):53–66. Available from:

Thaipisuttikul Y. Pruritic skin diseases in the elderly. J Dermatol 1998; 25: 153–7.

Bakker CV, Terra JB, Pas HH, Jonkman MF. Bullous Pemphigoid as Pruritus in the Elderly. JAMA Dermatology [Internet]. American Medical Association (AMA); 2013 Aug 1;149(8):950. Available from:

Levell NJ. Recognition and management of common causes of itchy skin. Nurs Resid Care 2008; 10: 188–91.

Yong AA, Cao T, Tan V, Yosipovitch G, Tey HL. Skin physiology in pruritus of advanced ageing. Journal of the European Academy of Dermatology and Venereology [Internet]. Wiley; 2015 Jan 21;30(3):549–50. Available from:

Van Os-Medendorp H, Guikers CLH, Eland-de Kok PCM, Ros WJG, Bruijnzeel-Koomen CAFM, Buskens E. Costs and cost-effectiveness of the nursing programme “Coping with itch” for patients with chronic pruritic skin disease. British Journal of Dermatology [Internet]. Wiley; 2008 May;158(5):1013–21. Available from:

Oros MM, Ivanyo TV. Itching and pain. Common pathophysiology and view of treatment. Health of Ukraine. Medical newspaper. 2018. № 1 (44). Pp. 23–24.

Свербіж як початок болю (Частина 3)



How to Cite

Kushnir V, Dmytrenko S, Katilov O, Kushnir N. Itching as the onset of pain (part 3). PMJUA [Internet]. 2020Jun.30 [cited 2020Aug.15];5(2):76-85. Available from: