Ep 9. Generalized Pruritus, JAK Inhibitors, and Other Itch Treatments with Diego Ruiz Dasilva, MD
カートのアイテムが多すぎます
カートに追加できませんでした。
ウィッシュリストに追加できませんでした。
ほしい物リストの削除に失敗しました。
ポッドキャストのフォローに失敗しました
ポッドキャストのフォロー解除に失敗しました
-
ナレーター:
-
著者:
Send us Fan Mail
Chronic Pruritus Workup & Treatment Pearls (CPUO, Neuropathic Itch, Nemolizumab, JAKs) | The Derm Resident
Contact: thedermresident.pod@gmail.com
Dr. Jonny Hatch hosts Dr. Diego Da Silva, a chronic pruritus expert and host of Skin In the Game, to discuss a practical approach to itch. They outline an initial framework based on distribution (localized vs generalized), time course (with shorter duration and older age raising concern for malignancy), and morphology (primary lesions vs excoriations only). For localized itch without rash, they emphasize neuropathic etiologies (notalgia paresthetica, brachioradial pruritus, meralgia, dysesthesias), consider spine wear-and-tear, and discuss PT plus gabapentinoids and other neuromodulators. For generalized pruritus without rash, they review ROS for constitutional symptoms, recommend considering biopsy of “normal” itchy skin (e.g., CTCL, sarcoid), and suggest labs (CBC, CMP, TSH, A1C, SPEP/IFE, ferritin, vitamin D), chest X-ray, and BP testing/DIF. Treatment pearls include skincare, phototherapy, atopic-directed therapies (dupilumab, nemolizumab), JAK inhibitor counseling (noting shingles risk and “JAKne”), and empiric ivermectin for possible scabies; off-label options include low-dose naltrexone, dronabinol, and intranasal butorphanol, plus advice for residents to develop a niche and “declare” expertise.
00:00 Show Introduction
00:59 Why Itch Matters
01:26 Finding a Niche
04:44 First Steps in Pruritus
07:00 Localized Itch Workup
09:02 Neuropathic Itch Treatments
11:32 Generalized Itch Workup
14:32 Labs Imaging and Biopsy
17:54 Treating CPUO Like Atopy
21:49 Choosing First Biologic
22:27 Nemolizumab Itch Breakthrough
23:58 JAK Inhibitors Safety Reality
26:08 Managing Shingles And Jackne
28:05 Treating Jackne Options
28:54 Derms As Real Doctors
30:54 Low Dose Naltrexone Role
32:15 Scabies And Empiric Ivermectin
33:09 Off Label Itch Rescue Meds
35:42 Advice And Podcast Wrap Up
Free The Derm Resident sticker for US Residents only: https://forms.gle/5mwsAotTomxgDt7F7