Itch Is Now Made Visible: Advances in fMRI and Its Relevance to Dermatology
- 1Department of Dermatology, University of California, San Francisco, San Francisco, California, USA
- 2Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
Abstract
Pruritus has long presented a diagnostic paradox in dermatology. Despite being among the most frequent patient complaints, it remains undervalued when unaccompanied by visible pathology. Bias toward visual cues in the field has often resulted in a tendency toward systematic neglect during clinical evaluation, and patients presenting with pruritus of unknown origin are frequently mischaracterized with factitious conditions. However, recent neuroimaging advances are revolutionizing our approach to pruritus by rendering central nervous system (CNS) itch pathways directly observable through functional magnetic resonance imaging (fMRI). Pioneering investigations have captured the neural signatures of centrally-originating pruritus, including socially-triggered, contagious itch and expectation-amplified itch through nocebo mechanisms. These studies reveal distinct brain activation patterns and have mapped core CNS-itch circuitry. Such neuroimaging capabilities hold promise for developing objective itch biomarkers, stratifying treatment candidates, and providing objective visual validation of patient-reported symptoms.
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BibTeX
@article{schandua2026itch,
title = {{Itch Is Now Made Visible: Advances in fMRI and Its Relevance to Dermatology}},
author = {Hayden Schandua and Catherine Kemeness and Amélie Spangenberg and Radhika Gupta and Wilson Liao and Nicholas Brownstone and John Koo},
journal = {Skin (Milwood, N.Y.)},
year = {2026},
month = sep,
doi = {10.25251/fhwg6k12},
url = {https://doi.org/10.25251/fhwg6k12},
note = {CC BY},
}
RIS
TY - JOUR
TI - Itch Is Now Made Visible: Advances in fMRI and Its Relevance to Dermatology
AU - Hayden Schandua
AU - Catherine Kemeness
AU - Amélie Spangenberg
AU - Radhika Gupta
AU - Wilson Liao
AU - Nicholas Brownstone
AU - John Koo
PY - 2026
DA - 2026/09/08
JO - Skin (Milwood, N.Y.)
DO - 10.25251/fhwg6k12
UR - https://doi.org/10.25251/fhwg6k12
AB - Pruritus has long presented a diagnostic paradox in dermatology. Despite being among the most frequent patient complaints, it remains undervalued when unaccompanied by visible pathology. Bias toward visual cues in the field has often resulted in a tendency toward systematic neglect during clinical evaluation, and patients presenting with pruritus of unknown origin are frequently mischaracterized with factitious conditions. However, recent neuroimaging advances are revolutionizing our approach to pruritus by rendering central nervous system (CNS) itch pathways directly observable through functional magnetic resonance imaging (fMRI). Pioneering investigations have captured the neural signatures of centrally-originating pruritus, including socially-triggered, contagious itch and expectation-amplified itch through nocebo mechanisms. These studies reveal distinct brain activation patterns and have mapped core CNS-itch circuitry. Such neuroimaging capabilities hold promise for developing objective itch biomarkers, stratifying treatment candidates, and providing objective visual validation of patient-reported symptoms.
SN - 2574-1624
ER -