Hachisuka Junichi, Takeuchi Satoshi, Kido Makiko, Fukiwake Noriko, Furue Masutaka
Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Int J Dermatol. 2009 Apr;48(4):374-8. doi: 10.1111/j.1365-4632.2009.03906.x.
Atopic dermatitis (AD) is a chronic, relapsing skin disease characterized by xerosis and pruritus. As pruritus is an unpleasant sensation and the associated scratching aggravates the skin eruption considerably, it is important to control this symptom when treating AD. Dry skin is generally considered to be a potential cause of pruritus in xerotic skin diseases, but a clear correlation between pruritus and atopic xerosis has not been demonstrated. Aim To examine the contribution of atopic xerosis to the development of pruritus in AD.
Twenty-two patients with AD (12 males and 10 females; mean age, 27.5 years) were examined. Xerosis and the severity of disease were evaluated using the Objective Severity Assessment of Atopic Dermatitis (OSAAD) and the SCORing Atopic Dermatitis (SCORAD) index, respectively. A modified SCORAD index was calculated by removing the symptoms potentially associated with pruritus (intensity of itching and insomnia) from the standard SCORAD index. Pruritus was evaluated using both a visual analog scale and the Verbal Itch Score.
The severity of AD (modified SCORAD index) correlated better than atopic xerosis (OSAAD score) with both pruritus scores, possibly indicating that the use of appropriate anti-inflammatory agents may be helpful in controlling pruritus as well as skin eruption in AD.
Our data suggest that the severity of disease (or skin inflammation) provides a greater contribution than xerosis to the development of pruritus in AD.
特应性皮炎（AD）是一种以皮肤干燥和瘙痒为特征的慢性复发性皮肤病。由于瘙痒是一种令人不适的感觉，且相关的搔抓会显著加重皮疹，因此在治疗AD时控制这一症状很重要。皮肤干燥通常被认为是干性皮肤病中瘙痒的一个潜在原因，但瘙痒与特应性皮肤干燥之间尚未证实存在明确关联。目的：研究特应性皮肤干燥对AD患者瘙痒发生的影响。
对22例AD患者（12例男性，10例女性；平均年龄27.5岁）进行检查。分别使用特应性皮炎客观严重程度评估（OSAAD）和特应性皮炎评分（SCORAD）指数评估皮肤干燥程度和疾病严重程度。通过从标准SCORAD指数中去除可能与瘙痒相关的症状（瘙痒强度和失眠）来计算改良的SCORAD指数。使用视觉模拟量表和言语瘙痒评分对瘙痒进行评估。
AD的严重程度（改良SCORAD指数）与两种瘙痒评分的相关性均优于特应性皮肤干燥（OSAAD评分），这可能表明使用适当的抗炎药物可能有助于控制AD患者的瘙痒以及皮疹。
我们的数据表明，在AD中，疾病严重程度（或皮肤炎症）对瘙痒发生的影响大于皮肤干燥。
