Considerable Variability in the Efficacy of 8% Capsaicin Topical Patches in the Treatment of Chronic Pruritus in 3 Patients with Notalgia Paresthetica

Notalgia paresthetica (NP) is a focal neuropathic itch condition manifesting in intense chronic or recurrent episodic itch in a hyperpigmented, macular, uni- or bilateral skin area located below and/or medially to the scapulae. Achieving satisfactory relieve in NP patients is challenging. In this case-series three female NP patients were treated with 8% capsaicin patches following a spatial quantification of their alloknetic area with a von Frey filament. The use of a von Frey filament in order to delimit the precise area of itch sensitization and thus patch application, proved clinically feasible. Although 8% topical capsaicin relieved itch in all three patients, the duration of the effectiveness varied greatly from only 3 days to >2 months. The treatment was well tolerated in the patients and there appear to be no significant hindrances to applying this treatment with NP as an indication, although it may only exhibit satisfactory effectiveness in certain patients. Placebo-controlled double-blinded trials are needed to confirm the effectiveness of the treatment and assess predictive parameters of the treatment outcome

Cryostratigraphy, sedimentology, and the late Quaternary evolution of the Zackenberg River delta, northeast Greenland

The Zackenberg River delta is located in northeast Greenland (74°30′ N, 20°30′ E) at the outlet of the Zackenberg fjord valley. The fjord-valley fill consists of a series of terraced deltaic deposits (ca. 2 km2) formed during relative sea-level (RSL) fall. We investigated the deposits using sedimentological and cryostratigraphic techniques together with optically stimulated luminescence (OSL) dating. We identify four facies associations in sections (4 to 22 m in height) exposed along the modern Zackenberg River and coast. Facies associations relate to (I) overriding glaciers, (II) retreating glaciers and quiescent glaciomarine conditions, (III) delta progradation in a fjord valley, and (IV) fluvial activity and niveo-aeolian processes. Pore, layered, and suspended cryofacies are identified in two 20 m deep ice-bonded sediment cores. The cryofacies distribution, together with low overall ground-ice content, indicates that permafrost is predominately epigenetic in these deposits. Fourteen OSL ages constrain the deposition of the cored deposits to between approximately 13 and 11 ka, immediately following deglaciation. The timing of permafrost aggradation was closely related to delta progradation and began following the subaerial exposure of the delta plain (ca. 11 ka). Our results reveal information concerning the interplay between deglaciation, RSL change, sedimentation, permafrost aggradation, and the timing of these events. These findings have implications for the timing and mode of permafrost aggradation in other fjord valleys in northeast Greenland

Cryostratigraphy, sedimentology, and the late Quaternary evolution of the Zackenberg River delta, northeast Greenland

The Zackenberg River delta is located in northeast Greenland (74°30′ N, 20°30′ E) at the outlet of the Zackenberg fjord valley. The fjord-valley fill consists of a series of terraced deltaic deposits (ca. 2 km2) formed during relative sea-level (RSL) fall. We investigated the deposits using sedimentological and cryostratigraphic techniques together with optically stimulated luminescence (OSL) dating. We identify four facies associations in sections (4 to 22 m in height) exposed along the modern Zackenberg River and coast. Facies associations relate to (I) overriding glaciers, (II) retreating glaciers and quiescent glaciomarine conditions, (III) delta progradation in a fjord valley, and (IV) fluvial activity and niveo-aeolian processes. Pore, layered, and suspended cryofacies are identified in two 20 m deep ice-bonded sediment cores. The cryofacies distribution, together with low overall ground-ice content, indicates that permafrost is predominately epigenetic in these deposits. Fourteen OSL ages constrain the deposition of the cored deposits to between approximately 13 and 11 ka, immediately following deglaciation. The timing of permafrost aggradation was closely related to delta progradation and began following the subaerial exposure of the delta plain (ca. 11 ka). Our results reveal information concerning the interplay between deglaciation, RSL change, sedimentation, permafrost aggradation, and the timing of these events. These findings have implications for the timing and mode of permafrost aggradation in other fjord valleys in northeast Greenland

Itch sensitization?:A systematic review of studies using quantitative sensory testing in patients with chronic itch

As well established for patients with chronic pain, patients suffering from chronic itch also exhibit signs of peripheral and central sensitization. This has been linked to parallel neuroplastic sensitization processes. However, for chronic itch, sensitization has not yet been systematically assessed, studied, and hence validated. This review (Prospero CRD42016043002) summarizes and meta-analytically evaluates whether sensory aberrations including sensitization for itch occur in chronic itch. Databases PubMed, Embase, and Cochrane Library were searched for studies investigating somatosensory sensitivity assessment by quantitative sensory testing stimuli, including experimental cutaneous chemical pruritic provocations, in patients with chronic itch from skin/neurological conditions and compared with healthy controls. Outcomes were extracted for lesional and nonlesional skin, and risk of biases were assessed. Meta-analyses were performed when sufficient quantitative data were available. Of 4667 identified articles, 46 were included and 25 were eligible for meta-analyses. Patients (66% atopic dermatitis [AD]) were found more sensitive than the controls to histamine-evoked itch in lesional skin (standardized mean difference [SMD]: 0.66 confidence interval [CI]: 0.16-1.15), but not nonlesionally (SMD: −0.26 [CI: −0.58 to 0.06]). Cowhage did not evoke more itch in nonlesional skin of patients as compared to the controls (SMD: 0.38 [CI: −0.04 to 0.81]). For numerous other chemical provocations as well as for mechanical, thermal, and electrical stimulation paradigms, results were ambiguous or based on few studies. Patients with chronic itch are only robustly sensitized to various chemical pruritic stimuli when applied lesionally. More studies on somatosensory aberrations in chronic itch conditions other than AD are needed to establish whether sensitization is robustly present across chronic itch conditions.Health and self-regulatio

Long-term CO₂ production following permafrost thaw

Thawing permafrost represents a poorly understood feedback mechanism of climate change in the Arctic, but with a potential impact owing to stored carbon being mobilized1–5. We have quantified the long-term loss of carbon (C) from thawing permafrost in Northeast Greenland from 1996 to 2008 by combining repeated sediment sampling to assess changes in C stock and>12 years of CO2 production in incubated permafrost samples. Field observations show that the active-layer thickness has increased by>1 cm yr−1 but thawing has not resulted in a detectable decline in C stocks. Laboratory mineralization rates at 5 ◦C resulted in a C loss between 9 and 75%, depending on drainage, highlighting the potential of fast mobilization of permafrost C under aerobic conditions, but also that C at near-saturated conditions may remain largely immobilized over decades. This is confirmed by a three-pool

Severe and ChRonic Atopic dermatitis Treatment CoHort (SCRATCH):A Danish Real-world Evidence Atopic Dermatitis Treatment Registry

Data from real-world use of new systemic treatments in atopic dermatitis (AD) is important for assessing safety and efficacy. The aim of this study is to describe the baseline characteristics of adult patients with moderate-to-severe AD enrolled in the Danish nationwide Severe and ChRonic Atopic dermatitis Treatment CoHort (SCRATCH) database, between October 2017 and August 2021. A total of 282 adult patients were included. Most (62%) were men, the median age at baseline was 43 years (interquartile range (IQR) 29–54 years), and median age at onset of AD was 1 year (IQR 0–6 years). The median Eczema Area and Severity Index at treatment initiation was 19.1 (IQR 11.9–25.7); median Patient Oriented Eczema Measure 21.0 (IQR 16.0–25.0); median Dermatology Life Quality Index 13.0 (IQR 7.0–19.0); and median itch and sleep numerical rating scale scores 8.0 (IQR 6.0–9.0) and 6.0 (IQR 4.0–8.0). Differences were found between the sexes. This registry will provide a source for future efficacy and safety studies