As I mentioned in an earlier post, J. does usually have scratching attacks 1-2 times a day, usually when we undress him in the morning or evening. With scratching attack I mean that he starts to scratch all exposed areas (hands, neck, legs, arms) very intensely. He takes off his pants (in case he still wears him) so he can better scratch his legs. He does not let me cream him and he starts to scream when I try to touch him. The only thing I can do is wait until he calms down a bit or bring my laptop and try to distract him with showing him a cartoon. Just letting him scratch is hard, but letting him scratch when he has a bacterial infection is unbearable. J. is now getting antibiotics for three days and it is amazing how quickly the bacterial infection heals off.

We are observing for a while already that there seems to be a strange pattern in the frequency of this scratching attacks: if J. does not have a scratching attack in the evening, he is more likely to wake up at night scratching, and if he does have a scratching attack at night, he is less likely to scratch in the morning. It almost seems as if something (histamine?) is getting depleted during scratching and it needs some time to replenish, or something else happens that involves a process with a slow time constant.  I really wished I knew more about the physiology of itch and had more time to read. We have our atopy consultation at the skin clinic on Wednesday and I am preparing a long catalog of questions I want to ask. I really hope that the doctor we are going to see there is knowledgeable and patient enough to answer all those questions…..

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