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Conference tackles mystery of why we itch

Itchiness

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Millions of people itch. At its worst, itching can bring about sleepless nights, unemployment, and divorce. Yet many doctors downplay the problem and have few treatments to offer.

Given such large numbers and high stakes, interest in itch is exploding among scientists and medical specialists, especially in Boston. About 250 researchers from as far away as Congo met here Sunday for the seventh World Congress on Itch — a conference designed to increase collaboration among scientists across specialties and countries to unravel the mystery of why people itch.

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To some in the field, itching is the new pain.

“There is frustration on the part of patients that itches aren’t being treated,’’ said Dr. Ethan Lerner, a dermatologist at Massachusetts General Hospital, who organized the conference. “Patients are desperate. Sometimes patients can become suicidal because the itching is so bad.’’

Itch is a component of many medical conditions, including renal failure, liver disease, and some cancers like Hodgkin’s lymphoma, which Lerner said includes “itching all over the body and no one knows why. There is no rash.’’ More than 31 million Americans suffer from the itchy skin condition eczema. And wounds and burns often itch uncontrollably as they heal.

In his remarks Sunday, Dr. Stephen Katz, director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, urged researchers to apply for federal grants to study the underlying causes of itch, even in these lean times for research funding.

“This is a high priority for us,’’ he said in an interview. “Itch is such a central issue in so many diseases.’’

Katz said he hopes the conference, which ends Monday, will further stimulate scientific interest and much-needed progress in the field. Many researchers discussed their work to identify nerve receptors and pathways that transmit the sensation of itch from the skin to the spinal cord and brain.

Dermatologist Dr. Suephy Chen and colleagues at Emory University in Atlanta have been trying to measure the number of people with chronic itch and the impact on their lives. In one study, they found that among more than 1,000 US veterans, about 30 percent suffered from chronic itch lasting at least six weeks, she said in an interview at the conference. About half the veterans itched for more than a decade. The research raised the question of whether post traumatic stress disorder and itch are connected.

Society has often made fun of itch; there’s the famous camp prank involving itching powder in the bunk. But Chen said some patients are too distracted to work or can’t sit still. Children with eczema sometimes get misdiagnosed as having attention deficit hyperactivity disorder. And in one survey she conducted of 73 patients who suffer from chronic itching, patients said they would give up an average of 13 percent of their lives to have the rest of their lives without itching.

She noted the dearth of effective treatments. Antihistamines do not work for all patients and steroids may stop itching but longterm use poses risks.

Itch is “one of the most dramatic unmet needs’’ Dr. David Fisher, a pediatric oncologist who heads Mass. General’s dermatology department, told scientists at Sunday’s meeting.

Lerner said that growing participation by neuroscientists, some of whom accidentally stumbled on itch nerve pathways while studying pain, has jump-started progress in the field. There is a new appreciation that itch is not just an immune response to an irritant on the skin, but also a neurological problem. “That’s why it’s so hard to treat. Putting something on the skin won’t treat the brain,’’ he said.

Companies are spotting opportunities; among those attending the congress were representatives from such businesses as Unilever, the maker of Dove and other soaps. Serious scientific journals like Cell and Nature are publishing papers on itching. And attendance at this year’s conference in Boston drew 100 more participants than the sixth Congress on Itch two years ago in France, Lerner said.

“One of the things we need to do in the field of itch is think outside the box,’’ Lerner told scientists Sunday.

Liz Kowalczyk can be reached at kowalczyk@globe.com. Follow her on twitter @GlobeLizK
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