Benjamin Kenneth, Waterston Karen, Russell Margaret, Schofield Olivia, Diffey Brian, Rees Jonathan L
Systems Group, Department of Dermatology, The University of Edinburgh, Lauriston, UK.
J Am Acad Dermatol. 2004 Jan;50(1):33-40. doi: 10.1016/s0190-9622(03)02480-0.
Itch is a major symptom of skin disease and remains poorly studied. We have used limb-worn digital accelerometers, and infrared video of patients as a gold standard, on children with atopic dermatitis and control subjects in their own homes at night. Video analysis shows that nocturnal scratching and restlessness are more complex than we first thought, with many movements that potentially damage the skin not conforming to stereotypical scratch movements. Children with atopic dermatitis spent a mean of 46 minutes less time motionless or sleeping at night than control subjects (468 +/- 3 [SEM] vs 422 +/- 37 [SEM], P<.001). Children with atopic dermatitis showed 2 to 3 times as much scratching or restlessness activity as control subjects, with little overlap between groups (P<.01). Scratching and restlessness were highly correlated with each other (0.94, P<.01). Accelerometer scores were highly correlated with video results (rho>0.02, P<.01, for scratching, restlessness, and sleeping time). Individual limb scores were highly correlated with each other (rho approximately 0.87-0.98), suggesting that little information would be lost if only 1 limb was measured. There was little relation between parental assessment of scratch and objective measured scratch. Accelerometers provide a useful and practical way of assessing scratching at night in the patient's own home and could be used as an objective measure of disease activity both in clinical trials and in everyday clinical practice.
瘙痒是皮肤病的主要症状，但相关研究仍然较少。我们让患有特应性皮炎的儿童和对照受试者夜间在家中使用腕戴式数字加速度计，并将患者的红外视频作为金标准。视频分析表明，夜间抓挠和不安比我们最初认为的更为复杂，许多可能损伤皮肤的动作并不符合刻板的抓挠动作。患有特应性皮炎的儿童夜间静止或睡眠的平均时间比对照受试者少46分钟（468±3[标准误]对422±37[标准误]，P<0.001）。患有特应性皮炎的儿童抓挠或不安活动是对照受试者的2至3倍，两组之间几乎没有重叠（P<0.01）。抓挠和不安彼此高度相关（0.94，P<0.01）。加速度计得分与视频结果高度相关（抓挠、不安和睡眠时间的rho>0.02，P<0.01）。各个肢体的得分彼此高度相关（rho约为0.87 - 0.98），这表明如果只测量一个肢体，几乎不会损失信息。家长对抓挠的评估与客观测量的抓挠之间几乎没有关系。加速度计为在家中评估患者夜间抓挠提供了一种有用且实用的方法，可在临床试验和日常临床实践中用作疾病活动的客观指标。
