Mechanisms of enhanced pruritogenicity of chloroquine among patients with malaria: a review

Abstract

The mechanisms whereby the intrinsic pruritogenic effect of chloroquine (a property also encountered among some other 4-amino-quinolines including amodiaquine) becomes aggravated during paroxysmal malarial suppressive chemotherapy with the drug form the basis of this paper. Physiological itching has been linked to the concept of 'spontaneous itch', as compared to pathological itching which has been associated with another concept of 'itching hyperexcitability', and the pathophysiology of pruritus, including the involvement of peripheral and central (neuropeptide) mediators of itch, were considered. The modulating function of spinal and supraspinal 'gateway control' mechanisms, which have been used to explain the overriding effect of pain-over-itch sensation, were also considered and related to itching hyperexcitability.