Ebata T, Aizawa H, Kamide R, Niimura M
Department of Dermatology, Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo 105-8461, Japan.
Br J Dermatol. 1999 Jul;141(1):82-6. doi: 10.1046/j.1365-2133.1999.02924.x.
Patients with atopic dermatitis (AD) are known to suffer from nocturnal itch, and the resultant scratching may worsen the skin lesions. We observed nocturnal scratching for 112 nights in 35 adult patients with AD, using an infrared video camera system. To quantify the amount of scratching, we counted scratching bouts lasting more than 5 s and calculated the duration of all the scratching bouts (total scratching time, TST). The percentage of TST in the total recording time (TST%) was used as an index of nocturnal scratching. Mean +/- SD TST% was 14.3 +/- 13.9 for patients with severe AD, 6.2 +/- 3.7 for those with moderate AD and 0.7 +/- 0.4 for those with mild AD. The higher TST% in the severely affected group was attributed mainly to a longer duration rather than a higher frequency of bouts. Patients scratched more in the first third of the night than in the later two-thirds. Both the group of patients whose disease distribution pattern was generalized and those who showed a head-neck-shoulder type distribution scratched their heads, faces and necks for longer than other parts of the body. Repeated measurement performed on individual subjects resulted in a similar TST% when there was little change in skin lesions. TST% reduced by 15 +/- 21% when the patients showed marked improvement. The measurement of nocturnal scratching helps to evaluate the severity of itch in AD. In addition, the infrared video successfully detected the location and nature of nocturnal scratching in AD.
已知特应性皮炎（AD）患者会遭受夜间瘙痒，由此产生的搔抓可能会使皮肤病变恶化。我们使用红外摄像系统，对35名成年AD患者的夜间搔抓情况进行了112个夜晚的观察。为了量化搔抓量，我们计算持续超过5秒的搔抓发作次数，并计算所有搔抓发作的持续时间（总搔抓时间，TST）。TST在总记录时间中的百分比（TST%）被用作夜间搔抓的指标。重度AD患者的平均±标准差TST%为14.3±13.9，中度AD患者为6.2±3.7，轻度AD患者为0.7±0.4。重度受累组较高的TST%主要归因于发作持续时间较长，而非发作频率较高。患者在夜间的前三分之一时间比后三分之二时间搔抓得更多。疾病分布模式为泛发型的患者组和表现为头颈部肩部型分布的患者组，其头部、面部和颈部的搔抓时间比身体其他部位更长。对个体受试者进行重复测量时，若皮肤病变变化不大，则TST%相似。当患者病情明显改善时，TST%降低了15±21%。夜间搔抓的测量有助于评估AD中瘙痒的严重程度。此外，红外摄像成功检测到了AD患者夜间搔抓的位置和性质。
