POST-BURN PRURITUS
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I am seeing an 18 year old boy who received burns over 90% of his body as a
result of an explosion in a fireworks factory last October. He wears total
body Jobst occlusion around rhe clock and must do so  for 2 more years. He 
is bothered by severe pruritus unrelieved by Atarax 100mg q4h, Periactin 4mg
qid,Doxepin 25mg qhs and Benadryl 50 mg qid(he can still function despite
these). Pramasone and Triamcinalone topically haven't helped. Any special
tricks to help the itching caused by still-healing skin or the occlusion? 
 

Harold Rehbein
Jacksonville,Fl.
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Theoretical: a naloxone patch   

Diane Thaler MD
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You may want to try having your patient wear "waffle-weave" underwear
under the Jobst garment. the lack of air circulation causes the "occlusive"
pruritus. I advise my steel worker patients of the same because they wear
fiberglass outer garments that do not "breathe". I think Sears sells this
type of undergarment or any of the sports stores. this is also a popular
item with cross-country skiiers. best of luck. :-)

Thomas F. Downham II, MD
Dermatology
Henry Ford Medical  Center
Taylor, MI
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Buspirone (Buspar) has been described as useful in atopic dermatitis (see 
SID annual meeting abstracts for 1996).  It seemed to suppress the pruritus 
in these patients.  The dose was 10 mg po tid.

Rjshar@aol.com
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I would try a nonsteroidal anti-inflammatory agent like ibuprofen.

Philip Hughes, M.D.
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				4.08.96