Yahya Argobi, Gideon P. Smith
J Drugs Dermatol. 2019 Oct 1;18(10):995-998.
Background: Autoimmune connective tissue diseases (ACTDs) are a broad range of diseases featured by immune dysregulation, and often have multisystem involvement with prominent skin manifestations. Pruritus is one of the most common symptoms in these diseases, with significant impact on the quality of life of patients. Objective: To characterize the frequency, location, severity, and timing relative to disease onset of pruritus in different ACTDs. Methods: A chart review of all patients seen in the Rheumatology-Dermatology clinic at Massachusetts General Hospital. Results: Itch was a troubling symptom in 83% of dermatomyositis (DM), 61% of systemic lupus erythematosus (SLE), 59% of Sjogren syndrome (SJO), 22% of systemic sclerosis (SSc), and 60% of mixed connective tissue disease. In DM and SLE, itch paralleled the course of inflammatory skin manifestations in 83% and 45%, respectively. Itch in DM is more intense and more treatment resistant in 12% vs 1% in SLE. In contrast, itch in SSc and SJO tended to occur later in the disease course, 86% vs 42%, respectively. Conclusion: Itch is common in all ACTDs and often under-evaluated and under treated. Pruritus is more common and more severe in DM than in SLE. Treatment of pruritus in ACTDs can be challenging, and sometimes multi-modal therapy is warranted. J Drugs Dermatol. 2019;18(10):995-998.
自身免疫性结缔组织病（ACTDs）是一类以免疫失调为特征的广泛疾病，常累及多系统，皮肤表现突出。瘙痒是这些疾病最常见的症状之一，对患者生活质量有显著影响。目的：描述不同自身免疫性结缔组织病中瘙痒的频率、部位、严重程度及与疾病发作相关的时间。方法：对麻省总医院风湿-皮肤科门诊所有患者的病历进行回顾。结果：瘙痒是皮肌炎（DM）患者中83%、系统性红斑狼疮（SLE）患者中61%、干燥综合征（SJO）患者中59%、系统性硬化症（SSc）患者中22%以及混合性结缔组织病患者中60%的困扰症状。在DM和SLE中，瘙痒分别在83%和45%的患者中与炎症性皮肤表现的病程平行。DM中的瘙痒比SLE中的更强烈且更难治疗，分别为12%和1%。相比之下，SSc和SJO中的瘙痒往往在疾病病程后期出现，分别为86%和42%。结论：瘙痒在所有自身免疫性结缔组织病中都很常见，且常未得到充分评估和治疗。DM中的瘙痒比SLE中更常见且更严重。自身免疫性结缔组织病中瘙痒的治疗可能具有挑战性，有时需要多模式治疗。《药物皮肤病学杂志》。2019年；18（10）：995 - 998。
