283 Dermatologic Therapy, Vol. 18, 2005, 283–287 Printed in the United States · All rights reserved Copyright © Blackwell Publishing, Inc., 2005 DERMATOLOGIC THERAPY ISSN 1396-0296 Blackwell Publishing, Ltd. Some historical and epistemological remarks on itch and pruritus MARGHERITA TERRANOVA*, CLAUDIO GUARNERI † , FABRIZIO GUARNERI † , GIUSEPPE TERRANOVA ‡ , & TORELLO LOTTI* *Department of Dermatological Sciences, University of Florence, † Department of Dermatological Sciences, University of Messina, and ‡ Maternal Department of Children, Division of Child Psychiatry and Neurology, University of Palermo, Italy ABSTRACT: Although very common, itch is very hard to describe. It can be considered as one of the most distressing physical sensations we experience. Going back historically, old Latin and Greek writers cited it in ancient papers. So, etymology is of central importance to investigation in the field of itch, regarding the formation of a word with antique origins and different meanings. Scientists, poets, and painters for centuries tried to describe and represent itch. The study of their work reveals the development of the itch’s significance. Today, a clinically relevant distinction defines pruritus and itch as two different sensations. Moreover, some terms like hyperknesis, alloknesis, atmoknesis, pro- topathic itch, and epicritic itch are described to approaching the complexity of this sensation and are utilized in clinical practice. KEYWORDS: etymology, history, itch, pruritus Introduction Itch has been considered one of the most distress- ing physical sensations one can experience. In severe cases, it can lead to sleep deprivation and can make life so miserable that it can contribute to significant psychological disturbances and lead to suicide (1,2). This probably induced Dante Alighieri to imagine itch to be the right punish- ment for falsifiers on the XXIX canto of the Inferno. In verses 79 –81 he wrote, “. . . come cias- cun menava spesso il morso dell’unghie sopra sè per la gran rabbia del pizzicor, che non ha più soccorso,” which means “. . . scratch themselves with nails over and over because of the burning rage of the fierce itching that nothing could relieve” (FIG. 1) (3). Alibert described the devastating effect of itch on Plato in the last years of his life and on Charles V and Charles IX. An interesting description is given by C. M. Gibert about the itch of the Abate Morellet who at the age of 24 could not sleep in the night and thus used to wash his skin repeat- edly with aceto saturnino. He wrote, “I am on the grill of St. Lorenzo.” Simultaneously, one soldier in the same castle described a similar itch as “mi sembra di esser continuamente punto da alabarde.” According to Gibert, clearly they are two different descriptions of the same sensation most probably for the same disease: one from the religious Abate (burning) and the other from the soldier (pricking). This is to help in understanding the following (4). Types of itch and pruritus Although very common, itch is very hard to describe and can be defined as “an uneasy sensation of the Address correspondence and reprint requests to: Claudio Guarneri, Department of Dermatological Sciences, University of Messina, Italy, or email: claudioguarneri@tiscali.it.