Prurido Crónico:  Fisiopatologia, Classificação Clínica, Diagnóstico e Tratamento

Manuel Pedro Pereira; Sonja Ständer

doi:10.29021/spdv.75.4.793

Manuel Pedro Pereira Hospital Universitário de Münster
Sonja Ständer Hospital Universitário de Münster

DOI: https://doi.org/10.29021/spdv.75.4.793

Palavras-chave: prurido, diagnóstico, tratamento, fisiopatologia, classificação

Resumo

Prurido com seis ou mais semanas de duração é considerado crónico (PC). Pode ter como origem causas dermatológicas, sistémicas, neurológicas, psicossomáticas ou psiquiátricas ou advir de uma combinação de vários factores. Devido a processos de cronificação, nomeadamente sensibilização neuronal periférica e central, o prurido pode persistir apresar do tratamento da causa subjacente. Além disso, PC leva frequentemente a doenças reativas, como depressão, ansiedade ou distúrbios de sono, tendo como consequência um substancial decréscimo da qualidade de vida. Devido à multidimensionalidade do PC, esta condição representa um desafio importante para o médico assistente. A classificação do doente com PC de acordo com a apresentação clínica facilita a orientação dos procedimentos de diagnóstico necessários bem como ajuda a estabelecer uma estratégia terapêutica. A nível terapêutico uma abordagem por etapas é recomendada. Primeiramente devem-se iniciar medidas básicas como a aplicação de emolientes para a xerose cutânea, corticoesteróides tópicos para pele inflamada ou com escoriações bem como o uso de medicamentos anti-histamínicos. Caso a origem do PC seja conhecida, deve-se proceder, se possível, ao tratamento da causa subjacente. Se a causa permanecer desconhecida ou não for passível de tratamento, uma terapia sintomática multimodal com agentes tópicos e sistémicos é frequentemente necessária. Com o aumento do conhecimento dos mecanismos patofisiológicos subjacentes ao PC, novos fármacos tem sido desenvolvidos mostrando resultados promissores.

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Biografias Autor

Manuel Pedro Pereira, Hospital Universitário de Münster

Afiliação:

Centro de Prurido Crónico, Departamento de Dermatologia, Hospital Universitário de Münster, Alemanha

Sonja Ständer, Hospital Universitário de Münster

Afiliação:

Centro de Prurido Crónico, Departamento de Dermatologia, Hospital Universitário de Münster, Alemanha

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