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Review
. 2025 Jun;23(6):721-745.
doi: 10.1111/ddg.15624. Epub 2025 May 22.

Supportive pain therapy in dermatology

Markus Werner  1 , Waltraud Stromer  2 , Svea Hüning  1 , Carmen Loquai  3 , Katharina Kähler  4 , Laura Susok  1 , Dorothée Nashan  1   5
Affiliations
Review

Supportive pain therapy in dermatology

Markus Werner et al. J Dtsch Dermatol Ges. 2025 Jun.

Abstract

In conservative dermatology, significant pain frequently presents as an accompanying symptom of complex and severe diseases, severely impacting patients' quality of life. Herpes zoster and pyoderma gangrenosum are two conditions commonly associated with pain. Supportive therapy refers to measures designed to alleviate and improve disease-related symptoms, such as pain, in addition to disease-specific treatments. This review focuses on strategies for targeted pharmacological pain management, addressing contraindications, usage restrictions, dosing, dose adjustments, and potential drug interactions. While nonopioid analgesics are central to pain management, carefully selected opioids are also utilized. However, these may negatively affect patients' well-being and treatment adherence due to side effects like constipation and nausea. As a result, a supportive adjunctive therapy to address these side effects is crucial. The principles of targeted pharmacological pain therapy, consistent with current guidelines and recommendations from professional societies, are outlined in this article for use in dermatological practice.

Keywords: herpes zoster; opioid induced constipation; pain; pain therapy; pyoderma gangraenosum; supportive therapy.

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