Department of Dermatology, Allergology and Venereology, Institute and Comprehensive Center for Inflammation Medicine, University Medical Center Schleswig-Holstein, Lübeck, Germany.
Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
J Eur Acad Dermatol Venereol. 2022 Nov;36(11):2064-2075. doi: 10.1111/jdv.18330. Epub 2022 Jun 28.
Pruritus is prevalent in psoriasis but still many features of pruritus, its response to therapy and its burden in psoriasis remain to be better characterized.
To investigate characteristics and burden of pruritus in an international cohort of patients with psoriasis.
This cross-sectional study included a total of 634 patients and 246 controls from Germany, Poland and Russia. Physicians examined and interviewed participants, recording clinical characteristics, such as severity, therapy and localization of psoriatic lesions. Participants filled out self-reported questionnaires including questions on pruritus severity and impact, characteristics, and response to therapy, and quality of life (QoL). Localization patterns of pruritus and skin lesions were visualized using body heat maps.
Most patients (82%) experienced pruritus throughout their disease, and 75% had current pruritus. The majority of patients (64%) perceived pure pruritus, and those who reported additional painful and/or burning sensations (36%) reported overall stronger pruritus. The scalp was the most frequently reported localization of pruritus, even in the absence of skin lesions. Body surface area (BSA) of pruritus was not linked to pruritus intensity, but to BSA of psoriatic lesions (rho = 0.278; P < 0.001). One third of patients (31%) reported impaired sex-life, and 4% had suicidal ideations due to pruritus. In up to one third of patients, psoriasis therapies had little or no effect on pruritus. The only therapeutic option offered to some of these patients were antihistamines, which appeared to be effective in most cases.
Pruritus is highly prevalent in psoriasis and is linked to a significant burden. Current psoriasis therapies are frequently insufficient to control pruritus. Managing psoriasis should include the assessment and control of itch. Efficient antipruritic therapies should be developed and be made available for patients with psoriasis.
瘙痒是银屑病的常见症状，但瘙痒的许多特征、其对治疗的反应以及在银屑病中的负担仍有待更好地描述。
调查国际银屑病患者队列中瘙痒的特征和负担。
这项横断面研究共纳入了来自德国、波兰和俄罗斯的 634 名患者和 246 名对照者。医生对参与者进行了检查和访谈，记录了临床特征，如银屑病病变的严重程度、治疗和定位。参与者填写了自我报告的问卷，包括瘙痒严重程度和影响、特征以及对治疗的反应和生活质量（QoL）的问题。使用体热图可视化瘙痒和皮肤病变的定位模式。
大多数患者（82%）在整个疾病过程中都经历过瘙痒，75%的患者目前有瘙痒。大多数患者（64%）感知到单纯瘙痒，而那些报告有额外疼痛和/或烧灼感的患者（36%）报告的瘙痒总体上更强。头皮是瘙痒最常报告的定位部位，即使没有皮肤病变。瘙痒的体表面积（BSA）与瘙痒强度无关，但与银屑病病变的 BSA 相关（rho=0.278；P<0.001）。三分之一的患者（31%）报告性生活受到影响，4%的患者因瘙痒而有自杀念头。多达三分之一的患者的银屑病治疗对瘙痒几乎没有或没有效果。这些患者中的一些人只能选择抗组胺药，而这些药物在大多数情况下似乎是有效的。
瘙痒在银屑病中非常普遍，且与显著的负担相关。目前的银屑病治疗方法通常不足以控制瘙痒。治疗银屑病应包括评估和控制瘙痒。应开发有效的止痒治疗方法，并为银屑病患者提供这些方法。
