Interleukin (IL)-31 has emerged as a pivotal mediator of pruritus. Since its initial identification, substantial progress has been made in elucidating the role of IL-31 in itch pathophysiology, particularly its direct effects on peripheral sensory neurons. Elevated IL-31 expression has been documented in a wide range of pruritic skin diseases, including atopic dermatitis, prurigo nodularis, and systemic disorders. Beyond its pruritogenic activity, IL-31 is increasingly recognized as a neuroimmune cytokine that links immune-cell activation to sensory-neuronal circuits and, in some contexts, may also exert immunomodulatory effects. IL-31 signals through a heterodimeric receptor complex composed of IL-31 receptor α and oncostatin M receptor β, activating downstream pathways. In sensory neurons, IL-31 receptor signaling defines a distinct pruritic pathway, but emerging human transcriptomic data indicate that IL-31-responsive neurons are more heterogeneous than the canonical murine NP3 subset, highlighting an important translational consideration. In this review, we summarize current knowledge regarding IL-31 biology, including its cellular sources, receptor expression, and signaling mechanisms, and discuss its role in both pruritic and non-pruritic diseases. We further evaluate therapeutic strategies targeting the IL-31/IL-31 receptor axis and consider the emerging concept that IL-31 blockade may relieve itch while simultaneously disinhibiting dendritic cell-driven type 2 inflammatory programs in selected contexts.

Neuroimmune interactions serve as a core regulatory node of chronic pain and pruritus and a key target for clinical intervention. Lipocalin-2 (LCN2), a member of the lipocalin superfamily, is a multifunctional protein widely expressed in various tissues and cells. LCN2 exerts diverse biological effects by regulating iron metabolism, mediating inflammatory responses, and participating in signal transduction pathways. In recent years, accumulating evidence has indicated that LCN2 plays a crucial role in the pathogenesis of chronic pain and pruritus through neuroinflammation, neuron-glia interactions, and modulation of neural signaling. In chronic pain, LCN2 contributes to the development and maintenance of inflammatory pain, neuropathic pain, morphine tolerance, and thalamic pain by disrupting iron homeostasis, inducing oxidative stress, and promoting central sensitization. For chronic pruritus, LCN2 modulates the excitability of pruritus-related neurons via pathways such as the IL-6/STAT3 axis, and participates in the pathological processes of pruritus in allergic contact dermatitis, xerosis, atopic dermatitis, and psoriasis. This review summarizes the structural characteristics, physiological functions of LCN2, and its specific mechanisms in regulating chronic pain and pruritus, and further discusses the potential therapeutic value of targeting LCN2, aiming to provide a theoretical basis for the development of novel interventions for chronic pain and pruritus.

Scabies is a contagious skin infestation of ongoing public health concern. This retrospective, descriptive study analyzed the epidemiological trends, clinical characteristics, and treatment outcomes of pediatric scabies in a tertiary care setting in Ankara, covering both pre- and post-earthquake periods between September 2019 and December 2023. Among 848 patients, representing 25% of all parasitic infections, case numbers showed a steady increase over the four-year period. The majority of patients (95.8%) resided in Central Anatolia, and 49% reported symptomatic household contacts. Pruritus (90.5%) and rash (78.3%) were the dominant symptoms, while secondary bacterial complications were rare (0.7%). Permethrin was the primary treatment (62.2%), yielding an 87.2% favorable clinical response. Recurrence occurred in 12.7% of cases. These descriptive findings highlight the steadily increasing burden of pediatric scabies in Central Anatolia and underscore the need for enhanced public health surveillance and comprehensive household-level management in urban settings.

Vancomycin is a widely used antibiotic, particularly for the treatment of resistant infections like methicillin-resistant Staphylococcus aureus (MRSA). While generally safe, vancomycin is associated with adverse reactions, most notably vancomycin flushing syndrome (VFS). VFS, a non-IgE-mediated histamine release, is often misdiagnosed as an allergic reaction, especially when presenting with symptoms such as pruritus, erythematous rash, and flushing. This case report discusses a 71-year-old female who initially presented with symptoms suggestive of an allergic reaction to vancomycin but was later diagnosed with VFS after a more thorough assessment. The patient with a BMI of 62.5, diagnosed with sepsis secondary to HAP caused by MRSA, developed an erythematous rash, dizziness, warmth, and pruritus two minutes after the initiation of vancomycin infusion at the rate of 17mg/min. Initially suspected to be an allergic reaction, the infusion was halted, and antihistamines were considered, however not given. Upon further evaluation, the diagnosis was revised to VFS. This case emphasizes the importance of differentiating between VFS and true allergic reactions in patients receiving vancomycin. Early recognition and prompt cessation of the infusion are critical in preventing further complications. Clinicians should consider VFS in patients with rapid-onset symptoms during vancomycin infusion.

Amyopathic dermatomyositis (ADM) is a rare variant of dermatomyositis characterised by the pathognomonic cutaneous features of the disease in the absence of clinically significant muscle weakness for at least 6 months. Peripheral eosinophilia is an uncommon laboratory finding associated with ADM and is more commonly linked to allergic, parasitic or haematological disorders.We present the case of a woman in her 70s with classic cutaneous signs of dermatomyositis associated with pruritus for 3 years, preserved muscle strength and persistent peripheral eosinophilia. Secondary causes of eosinophilia were excluded, and a diagnosis of ADM was made based on clinical features and antibody positivity. The patient showed an adequate response to systemic corticosteroids, with resolution of skin lesions and normalisation of eosinophil counts.This case highlights the importance of considering ADM in patients presenting with unexplained eosinophilia and characteristic cutaneous manifestations and adds to the limited literature describing eosinophilic manifestations in inflammatory myopathies.

Pediatric hepatocellular carcinoma (HCC), a rare and life-threatening malignancy that typically arises de novo, is strongly associated with underlying metabolic or genetic disorders. Its molecular pathogenesis remains poorly understood due to the limited number of well-documented cases. Herein, we present the case of an 11-year, 5-month-old boy who presented with incidentally detected cirrhosis, growth retardation, and severe pruritus. Whole-exome sequencing revealed a novel homozygous variant in the mitochondrial transcription factor A (TFAM) gene (c.197C>A; p.Pro66His) and compound heterozygous variants in the tight junction protein 2 (TJP2) gene (c.142G>C; p.Val48Leu and c.877C>T; p.Arg293Trp), all classified as variants of uncertain significance (VUS). Immunohistochemistry confirmed reduced expression of TFAM and TJP2, while electron microscopy demonstrated abnormal mitochondrial ultrastructure and compromised biliary epithelial integrity, supporting a diagnosis of combined TFAM and TJP2 deficiency. The disease rapidly progressed from moderately to well-differentiated HCC within 15 months. Following laparoscopic tumor resection, the patient successfully underwent orthotopic liver transplantation at 13 years of age, with normal graft function maintained at the 8-month follow-up. This case provides insights for the diagnosis and management of pediatric liver disease involving multiple VUS, suggests a potential novel pathogenic mechanism of HCC, and highlights the possible synergistic effects of multigene variants. Whether combined TFAM and TJP2 deficiencies directly and synergistically accelerate liver disease progression and hepatocarcinogenesis warrants further validation through additional clinical cases and functional studies.

Dermatitis rash (DR), a prevalent inflammatory skin disorder marked by erythema, pruritus, and scaling, poses diagnostic challenges due to overlapping phenotypes with atopic dermatitis and psoriasis. This study examines the relationship between serum platelet (PLT) levels and DR, as the PLT-DR link remains unknown. We used the China Health and Nutrition Survey (CHNS) database, 7,337 participants (172 DR cases, 7,165 controls) were analyzed. Baseline characteristics were compared via weighted chi-square tests. Multifactor regression models and weighted logistic regression assessed the PLT-DR relationship, while restricted cubic splines (RCS) explored nonlinear associations. The impact of age and sex was also evaluated. We found PLT levels significantly reduced DR risk (model 1: odds ratios (OR) = 0.9974 [95% confidence intervals (CI) = 0.9951-0.9998], P = 0.0316; model 2: OR = 0.9976 [95% CI = 0.9953-0.9999], P = 0.0490; model 3: OR = 0.9975 [95% CI = 0.9950-0.9999], P = 0.0398). Covariates such as previous smoking and rural residency were significantly associated with DR. Nonlinear models and risk stratification confirmed these findings, with female sex moderating the PLT-DR relationship. This elucidates that higher PLT levels may independently lower DR risk, suggesting diagnostic potential. PLT thresholds may enhance risk prediction models, aiding early intervention in high-risk populations.

IntroductionNUT carcinoma (NC) is a rare, aggressive squamous-lineage malignancy characterized by NUTM1 gene rearrangement and distinctive nuclear NUT expression by immunohistochemistry. Ocular adnexal involvement is exceptional.Patient presentationA 26-year-old woman presented with redness, pruritus, and a large nasal canthal mass obstructing vision in the left eye. Examination showed a 4 × 3 cm lacrimal mass extending into the extraconal orbit with extraocular muscle compression. Histology showed nests of small round blue cells with crush artifact and abrupt keratinization. Immunohistochemistry demonstrated diffuse pan-keratin, p63, p40, and speckled nuclear NUTM1 positivity; CD99 and NKX2.2 were negative-confirming NC.ConclusionLacrimal sac/gland NC should be considered in rapidly enlarging medial canthal masses in young patients. Prompt biopsy with IMMUNOHISTOCHEMISTRY for NUT and early multidisciplinary management are critical.

This study evaluates the effectiveness of combining ozone hydrotherapy with scalp complex acid in treating scalp seborrheic dermatitis (SSD).

Vulvar lymphangioma circumscriptum is a rare, benign lymphatic malformation that can mimic infectious or neoplastic lesions, often leading to delayed diagnoses. This report presents the case of a 48-year-old woman who presented with a 10-year history of wart-like lesions on the vulva, causing soreness, pruritus, and an impaired quality of life. Examination revealed multiple fluid-filled papules and swelling of the left labia majora. She underwent surgical excision, and histopathology confirmed lymphangioma circumscriptum without evidence of malignancy. At 12-month follow-up, she remained asymptomatic with no recurrence. This case highlights the importance of considering lymphangioma circumscriptum in chronic vulvar lesions and demonstrates that surgical excision can provide effective symptom relief.