Allergy. Author manuscript; available in PMC Apr 1, 2013. Published in final edited form as:Allergy. Apr 2012; 67(4): 566–573.Published online Feb 8, 2012. doi: 10.1111/j.1398-9995.2012.02789.xPMCID: PMC3303983NIHMSID: NIHMS347294Acupuncture compared to oral antihistamine for type I hypersensitivity itch and skin response in adults with atopic dermatitis – a patient and examiner blinded, randomized, placebo-controlled, crossover trialFlorian Pfab, MD,1,2,3 Marie-Therese Kirchner,3 Johannes Huss-Marp, MD,1,3 Tibor Schuster, PhD,4 Peter C. Schalock, MD,5 Jiang Fuqin, MD,1,3 Georgios I. Athanasiadis, MD,1 Heidrun Behrendt, MD,3 Johannes Ring, MD, PhD,1 Ulf Darsow, MD,1,3 and Vitaly Napadow, PhD2Author information ► Copyright and License information ► The publisher's final edited version of this article is available at AllergySee other articles in PMC that cite the published article. Go to:AbstractBackground
Itch is the major symptom of atopic dermatitis (AD). Acupuncture has been shown to exhibit a significant effect on experimental itch in AD. Our study evaluated acupuncture and anti-histamine itch therapy (cetirizine) on type-I-hypersensitivity itch and skin reaction in AD using a patient and examiner blinded, randomized, placebo-controlled, crossover trial.
Allergen–induced itch was evaluated in 20 AD patients after several interventions in separate sessions: preventive (preceding) and abortive (concurrent) verum acupuncture (VAp and VAa), cetirizine (10mg, VC), corresponding placebo interventions (preventive, PAp, and abortive, PAa, placebo acupuncture; placebo cetirizine pill, PC), and a no-intervention control (NI). Itch was induced on the forearm and temperature modulated over 20 minutes, using our validated model. Outcome parameters included itch intensity, wheal and flare size, and the D2 Attention test.
Mean itch intensity (SE: 0.31 each) was significantly lower following VAa (31.9) compared to all other groups (PAa: 36.5; VC: 36.8; VAp: 37.6; PC: 39.8; PAp: 39.9; NI: 45.7, p<0.05). There was no significant difference between VAp and VC (p>0.1), though both therapies were significantly superior to their respective placebo interventions (p<0.05). Flare size following VAp was significantly smaller (p=0.034) than PAp. D2 attention test score was significantly lower following VC compared to all other groups (p<0.001).
Both VA and cetirizine significantly reduced type-I-hypersensitivity itch in AD patients, compared to both placebo and NI. Timing of acupuncture application was important, as VAa had the most significant effect on itch, potentially due to counter-irritation and/or distraction. Itch reduction following cetirizine coincided with reduced attention.
Keywords: Itch, allergen, acupuncture, atopic eczema, cetirizine, attention