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Thiamine, Cobalamin, Locally Injected Alone or Combination for Herpetic Itching: A Single-Center Randomized Controlled Trial

Xu, Gang MD; Lv, Zhong-Wei PhD; Xu, Gang (Xiao) BSc; Tang, Wei-Zhen BSc

doi: 10.1097/AJP.0b013e3182a0e085
Original Articles

Objectives: The present study was designed to explore the efficacy of locally injected thiamine or cobalamin in relieving itch or pain and improving the daily living activities among patients with herpetic itching.

Methods: Eighty eligible patients with herpetic itching with a worst itching score of ≥4 were randomized to receive locally injected thiamine (B1 group), cobalamin (B12 group), lidocaine (LD group), or combination of thiamine and cobalamin (COB group) for 4 weeks. The treatment efficacy was assessed based on the patients’ pruritus and pain severity, global impression of change, and activities of daily living and quality of life.

Results: After 7 days, thiamine yielded a significant itch relief, cobalamin yielded a significant pain relief, and their combination significantly relieved both pain and itch; which all continued till the endpoint (all Ps<0.001). However, lidocaine did not provide significant itch or pain relief than the other groups. Sixteen patients in the thiamine group achieved ≥30% itch reduction; 18 patients in the cobalamin group obtained ≥30% pain reduction; and 18 patients achieved ≥30% itch reduction and 19 patients obtained ≥30% pain reduction in the combination group. The activities of daily living and quality of life data at the endpoint were consistent with a significant benefit in the thiamine (P<0.05), cobalamin, and combination groups (both Ps<0.001).

Discussion: Locally injected thiamine had a significant antipruritic effect, cobalamin had an analgesic effect, and their combination had the dual effect with no obvious synergies. This intervention was efficacious, tolerable, and safe for herpetic itching.

Department of Rehabilitation Medicine, Affiliated Tenth People’s Hospital of Tongji University, Shanghai, China

The authors declare no conflict of interest.

Reprints: Gang Xu, MD, Department of Rehabilitation Medicine, Affiliated Tenth People’s Hospital of Tongji University, 301 Middle Yanchang Road, Shanghai 200072, China (e-mail: shiter@yeah.net).

Received September 13, 2012

Accepted April 5, 2013

© 2014 by Lippincott Williams & Wilkins