Department of Dermatology, Competence Center for Chronic Pruritus, University Hospital Münster, Münster, Germany.
Competence Center for Healthcare Research in Dermatology (CVderm), Institute for Healthcare Research in Dermatology and Nursing (IVDP), University Hospital of Hamburg-Eppendorf, Hamburg, Germany.
J Eur Acad Dermatol Venereol. 2018 Jul;32(7):1059-1065. doi: 10.1111/jdv.14570. Epub 2017 Sep 22.
The term prurigo has been used for many decades in dermatology without clear definition, and currently used terminology of prurigo is inconsistent and confusing. Especially, itch-related prurigo remains unexplored regarding the epidemiology, clinical profile, natural course, underlying causes, available treatments and economic burden, although burdensome and difficult to treat.
To address these issues, the multicentre European Prurigo Project (EPP) was designed to increase knowledge on chronic prurigo (CPG). In the first step, European experts of the EADV Task Force Pruritus (TFP) aimed to achieve a consensus on the definition, classification and terminology of CPG. Additionally, procedures of the cross-sectional EPP were discussed and agreed upon.
Discussions and surveys between members of the TFP served as basis for a consensus conference. Using the Delphi method, consensus was defined as an agreement ≥75% among the present members.
Twenty-four members of the TFP participated in the consensus conference. Experts consented that CPG should be used as an umbrella term for the range of clinical manifestations (e.g. papular, nodular, plaque or umbilicated types). CPG is considered a distinct disease defined by the presence of chronic pruritus for ≥6 weeks, history and/or signs of repeated scratching and multiple localized/generalized pruriginous skin lesions (whitish or pink papules, nodules and/or plaques). CPG occurs due to a neuronal sensitization to itch and the development of an itch-scratch cycle.
This new definition and terminology of CPG should be implemented in dermatology to harmonize communication in the clinical routine, clinical trials and scientific literature. Acute/subacute forms of prurigo are separated entities, which need to be differentiated from CPG and will be discussed in a next step. In the near future, the cross-sectional EPP will provide relevant clinical data on various aspects of CPG leading to new directions in the scientific investigation of CGP.
几十年来，皮肤科一直使用瘙痒症一词，但没有明确的定义，目前使用的瘙痒症术语不一致且令人困惑。特别是，尽管瘙痒症相关的瘙痒症具有负担性且难以治疗，但在流行病学、临床特征、自然病程、潜在原因、现有治疗方法和经济负担方面仍未得到探索。
为了解决这些问题，欧洲多中心瘙痒症项目（EPP）旨在增加对慢性瘙痒症（CPG）的了解。在第一步中，EADV 瘙痒症工作组（TFP）的欧洲专家旨在就 CPG 的定义、分类和术语达成共识。此外，还讨论并商定了横断面 EPP 的程序。
TFP 成员之间的讨论和调查为共识会议提供了基础。使用 Delphi 方法，共识定义为出席成员之间的一致意见≥75%。
TFP 的 24 名成员参加了共识会议。专家们一致认为，瘙痒症应作为一系列临床表现（如丘疹、结节、斑块或脐状型）的总称使用。CPG 被认为是一种独特的疾病，其特征为慢性瘙痒≥6 周，有反复搔抓的病史和/或迹象，以及多发性局限性/全身性瘙痒性皮肤损伤（白色或粉红色丘疹、结节和/或斑块）。CPG 是由于对瘙痒的神经元敏化以及瘙痒-搔抓循环的发展引起的。
应在皮肤病学中实施 CPG 的这一定义和术语，以协调临床常规、临床试验和科学文献中的沟通。瘙痒症的急性/亚急性形式是分离的实体，需要与 CPG 区分开来，这将在下一步中进行讨论。在不久的将来，横断面 EPP 将提供关于 CPG 各个方面的相关临床数据，为 CPG 的科学研究提供新的方向。
