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Clinical and Histopathological Features of Post Burn Pruritus

Kwak, In Suk MD; Park, Sook Young MS; Choi, Young Hee MD; Cho, Soo Ick MD; Yang, Yoon Seok MD; Cho, Yong Se MD; Choi, Min Gyu PhD; Seo, Cheong Hoon MD; Park, Chun Wook MD; Kim, Hye One MD

doi: 10.1097/BCR.0000000000000392
Original Articles

The aim of the study was to evaluate the clinical and histopathological characteristics of patients with post burn pruritus. The authors took skin samples from 62 burn patients with or without pruritus. The measured skin condition includes thickness and paresthesia. Various clinical features were rated on patient assessment scale (PSAS) and observer scar assessment scale. The samples were stained with hematoxylin & eosin, Masson’s trichrome, Verhoeff’s elastic, and toluidine blue stain. The stained samples were analyzed in terms of epidermal thickness, mononuclear cell infiltration, collagen bundles, elastic fibers, and mast cell distribution. A total of 62 patients were divided into group A (43 patients with pruritus) and group B (19 patients without). The mean (±SD) intensity of itch in group A patients was 4.58 (±3.24). Group A patients had thickened epidermises and higher scores on the PSAS and observer scar assessment scale, especially on the PSAS score. Sensations, including stinging and electric shock sensations, were more frequent in group A than in group B. Histological analysis revealed that group A patients had thinner collagen bundles and more increased mast cell counts, while others did not. Patients suffering from post burn pruritus had distinctive clinical and histopathological features, such as prominent mast cell deposition and thin collagen bundles, compared with group B patients. These results may help better understand post burn pruritus.

From the *Departments of Anesthesiology and Pain Medicine, Dermatology, Pathology, Hallym University, Seoul, Korea; §Department of Computer Science, Kwangwoon University, Seoul, Korea; and Rehabilitation Medicine, College of Medicine, Hallym University, Seoul, Korea.

This research was supported by the National Research Foundation of Korea (NRF(NRF-2014R1A1A3A04049491)) funded by the Ministry of Sceince, ICT (HURF-2014-53 , HURF-2014-58).

Young Hee Choi and Sook Young Park contributed equally and should be considered co-first authors.

Address correspondence to Hye One Kim, MD, Department of Dermatology, College of Medicine, Hallym University, Kangnam Sacred Heart Hospital, 948-1, Daerim 1-dong, Yeungdeungpo-gu, Seoul, Korea. Email: hyeonekim@hallym.or.kr.

© 2016 The American Burn Association