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Aktuelle Dermatologie 2009; 35(8/09): 334-338
DOI: 10.1055/s-0028-1103422
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Pruritus bei Kindern[*]

Pruritus in ChildrenS.  Ständer1
  • 1Kompetenzzentrum Pruritus, Klinik und Poliklinik für Hautkrankheiten, Universitätsklinikum Münster
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Publication History

Publication Date:
27 November 2008 (online)

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Zusammenfassung

Akuter und chronischer (über 6 Wochen dauernder) Pruritus kann schon im Kindesalter auftreten. Chronischer Pruritus ist bei Kindern seltener als bei Erwachsenen (ca. 2 – 3 % Prävalenz). Schon bei Säuglingen kann das Symptom im Rahmen von Dermatosen beobachtet werden; die Pruritusstärke (und vermutlich auch Qualität) kann erst ab dem 6. Lebensjahr von den Kindern angegeben werden. Akuter und auch chronischer Pruritus tritt bei Kindern am häufigstem im Rahmen von Dermatosen (z. B. atopische Dermatitis, Psoriasis), gefolgt von cholestatischen Lebererkrankungen (z. B. M. Alagille) auf. Interessanterweise geben nur ca. 9 % der dialysepflichtigen nierenerkrankten Kinder einen Pruritus an, im Gegensatz zu den Erwachsenen (ca. 20 %). Selten kann ein Tumor des ZNS, z. B. ein Neurofibrom oder Astrozytom, lokalisierten neuropathischen Pruritus bei Kindern auslösen. Viele der systemischen antipruritisch wirksamen Therapien stehen Kindern primär nicht zur Verfügung. Neuere Studien belegen die Wirksamkeit von Naltrexon, Gabapentin und auch Cyclosporin A bei chronischem Pruritus im Kindesalter.

Abstract

Acute and chronic (> 6 weeks) pruritus can be observed in children usually less frequent than in adults (around 2 – 3 % prevalence). Even infants experience pruritus along with the occurrence of dermatoses. Pruritus intensity and probably also quality is differentiated by the children by the age of 6 years. In children, acute and chronic pruritus appears most often in dermatoses (e. g., atopic dermatitis, psoriasis) followed by cholestatic liver diseases (e. g. Alagille’s syndrome). Interestingly, only 9 % of children with dialysis due to chronic kidney disease report on chronic pruritus in contrast to high rate as observed in adults (20 %). Very rarely tumours of the CNS such as neurofibroma or astrocytoma lead to localised neuropathic pruritus in children. Most of systemically antipruritic therapies can not be applied in children. Recent studies demonstrated efficacy of naltrexone, gabapentine and cyclosporin in chronic pruritus in children.

1 Gehalten als Vortrag beim 2. Wiesbadener Symposium Kinderdermatologie, 12. 11. 2008.

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1 Gehalten als Vortrag beim 2. Wiesbadener Symposium Kinderdermatologie, 12. 11. 2008.

Prof. Dr. Sonja Ständer

Kompetenzzentrum Pruritus
Klinik und Poliklinik für Hautkrankheiten
Universitätsklinikum Münster

Von-Esmarchstr. 58
48149 Münster

Email: sonja.staender@uni-muenster.de