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Open Access Hydroxyethyl Starch-induced Pruritus: Clinical Characteristics and Influence of Dose, Molecular Weight and Substitution

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Severe persistent pruritus is a common, but incompletely characterized, complication of hydroxyethyl starch (HES) infusion. This retrospective study aimed to assess HES-induced pruritus by electron microscopic findings, pruritus characteristics, and response to stimuli, and to determine the impact of HES dosage, molecular weight and substitution. Seventy patients with electron microscopy-proven HES-induced pruritus were included. HES-laden vacuoles were observed in skin macrophages of all patients. The median latency between HES exposure and pruritus onset was 3 weeks, and the median duration of pruritus was 6 months. Pruritus was severe, or very severe, in 80% of patients. Mechanical stimuli triggered pruritus in 74% of patients. Although the median cumulative dose of HES was 300 g, 15% of patients developed pruritus after only 30 g. There were no significant differences between HES 130/0.4 and HES 200/0.5 in pruritus latency, duration or severity. HES-induced pruritus thus may occur at any dose, molecular weight or substitution.

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Keywords: DOSE; HYDROXYETHYL STARCH; MOLAR SUBSTITUTION; MOLECULAR WEIGHT; PRURITUS; TISSUE STORAGE

Document Type: Research Article

Publication date: May 1, 2014

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  • Acta Dermato-Venereologica is a bi-monthly international peer-reviewed journal for clinical and experimental research in the field of dermatology and venereology.

    It was founded in 1920 by Johan Almqvist and edited during 1936-1969 by Sven Hellerström. Since 1970, the journal has been published for the Society for the Publication of Acta Dermato-Venereologica on a non-profit basis.

    Acta Dermato-Venereologica publishes high-quality manuscripts in English dealing with new observations on basic dermatological and venereological research, as well as clinical investigations. Each volume also features a number of review articles in special areas, as well as short Letters to the Editor to stimulate debate and to disseminate important clinical observations. Acta Dermato-Venereologica has rapid publication times and is amply illustrated with a large number of colour photographs to enhance understanding.

    Acta Dermato-Venereologica covers inter alia:

    • ~ Atopic dermatitis and contact allergy
    • ~ Facial dermatoses and adnexal disorders
    • ~ New treatments
    • ~ Psoriasis and genodermatoses
    • ~ Psychodermatology
    • ~ Sexually transmitted diseases
    • ~ Skin biology and inflammation
    • ~ Skin cancer and pigmentation
    • ~ Skin immunology and lymphoma
    • ~ Urticaria and itch

    Extensive papers, proceedings from congresses and symposia are printed as supplements to the journal. Announcements concerning pertinent dermatological meetings and books received are also published.
    Readership: Doctors and scientists interested in dermatology, skin biology and venereology.

    Acta Dermato-Venereologica has an impact factor of 3.007.

    Issues between 1998 up to 2005 can be found at http://www.medicaljournals.se/acta/content

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