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Introduction: Atopic dermatitis (AD) is a chronic, relapsing, inflammatory skin disease characterized by eczema and pruritus, and frequently impairs sleep quality. Although cyclosporine improves symptoms of AD, objective evaluation of sleep in patients with AD treated with cyclosporine has not been reported. This study was conducted to elucidate the effects of cyclosporine on sleep quality for patients with AD. Methods: Twelve patients with moderate-to-severe AD were recruited. Nocturnal sleep quality was evaluated for 7 days using a sleep analyzer, which patients wore at the waist before and after cyclosporine was administered at 2.0–4.0 mg/kg per day. Seven parameters of sleep quality were measured before and after cyclosporine administration for a period of 7 days for each patient. Results: The administration of cyclosporine significantly improved total sleep time in four cases, sleep latency in two cases, wake after sleep onset in six cases, number of awakenings in two cases, sleep efficiency in seven cases, number of awakenings for more than 8 min in three cases, and number of position changes recorded every 2 min in three cases. The mean values of sleep latency significantly decreased after cyclosporine administration (P = 0.023). The mean value of sleep efficiency significantly increased after the administration (P = 0.002). Conclusion: Cyclosporine improves sleep quality in patients with moderate-to-severe AD. [ABSTRACT FROM AUTHOR]

Neuroimaging studies have examined the neural networks activated by pruritus but not its behavioral response, scratching. In this study, we examine the central sensory effects of scratching using blood oxygen level-dependent functional magnetic resonance imaging (fMRI) in 13 healthy human subjects. Subjects underwent functional imaging during scratching of the right lower leg. Scratching stimulus was started 60 seconds after initiation of fMRI acquisition and was cycled between 30-second duration applications of scratching and 30-second duration applications of no stimuli. Our results show that repetitive scratching induces robust bilateral activation of the secondary somatosensory cortex, insular cortex, prefrontal cortex, inferior parietal lobe, and cerebellum. In addition, we show that the same stimulus results in robust deactivation of the anterior and posterior cingulate cortices. This study demonstrates brain areas (motor, sensory, and non-sensory) activated and deactivated by repetitive scratching. Future studies that investigate the central effects of scratching in chronic itch conditions will be of high clinical relevance.Journal of Investigative Dermatology (2008) 128, 1806–1811; doi:10.1038/jid.2008.3; published online 31 January 2008 [ABSTRACT FROM AUTHOR]

Pruritus is exacerbated at night in many systemic and dermatological diseases, resulting in reports of significantly diminished quality of life and sleep disturbances. At present, the underlying mechanisms responsible for night-time itching are not well understood. Nocturnal pruritus may be related to the circadian rhythm of itch mediators and possibly the disruption of such patterns. Diurnal changes in skin physiology, such as temperature and barrier function, may also play a role. Currently, the paucity of specific treatment options for nocturnal pruritus is alarming and needs to be addressed by future research. This review describes the scale of the problem associated with nocturnal pruritus, the impact it has on patients, possible underlying mechanisms and, lastly, treatment options. [ABSTRACT FROM AUTHOR]