Soares Georgia Biazus, Orfali Raquel Leão, Averbach Beatriz Lacerda, Yap Qai Ven, Yosipovitch Gil, Aoki Valeria
Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
Department of Dermatology, Faculty of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
An Bras Dermatol. 2025 Jul-Aug;100(4):101093. doi: 10.1016/j.abd.2024.09.006. Epub 2025 Mar 11.
Chronic pruritus is the defining symptom of atopic dermatitis (AD). Although AD is common in Latin America, there is little data regarding pruritus intensity, characteristics, and effects on quality of life in this population.
This cross-sectional study aimed to evaluate pruritus in 91 patients with AD at a tertiary university hospital in São Paulo, Brazil. Patients aged 14‒65-years old were included in this study.
Patients completed the Itch Questionnaire, the ItchyQoL, and the POEM questionnaires and were asked to rate their itch severity using a 10-point peak pruritus Numerical Rating Scale (NRS). AD severity was assessed via the EASI and the vIGA-AD.
The mean age was 29.68 ± 12.87years, and 56.0% of patients were White. 97.8% of patients were currently experiencing pruritus with an average NRS of 7.32 ± 2.22. Patients had associated bleeding (71.4%), heat sensation (63.7%), and pain (54.9%). Worsening factors included stress (93.4%), dry skin (91.2%), and sweat (75.8%). The mean total ItchyQoL score was 78.93 ± 17.20. Female gender was significantly associated with a higher total ItchyQoL score (p = 0.009). Pruritus on the neck, foot, and whole body was associated with higher total ItchyQoL scores in adjusted models (p < 0.05). The EASI, vIGA-AD, and POEM were moderately correlated with itch intensity (r = 0.434, 0.406, and 0.610) and total ItchyQoL score (r = 0.425, 0.436, and 0.631).
The predominantly White population cohort may not be representative of the diverse AD phenotypes in the Brazilian patient population. Children under the age of 14 and adults over the age of 65 were excluded from the population cohort. Furthermore, patients included in the study may suffer from other non-dermatological diseases that cause itch, which may influence the outcomes oberserved.
Patients with AD in Brazil experience significant pruritus that impacts their quality of life. Gender, body location of itch, associated pain, and stress should all be taken into consideration when evaluating AD patients with pruritus.
慢性瘙痒是特应性皮炎（AD）的主要症状。尽管AD在拉丁美洲很常见，但关于该人群瘙痒强度、特征及其对生活质量影响的数据却很少。
这项横断面研究旨在评估巴西圣保罗一家三级大学医院的91例AD患者的瘙痒情况。本研究纳入了年龄在14至65岁之间的患者。
患者完成了瘙痒问卷、瘙痒生活质量问卷（ItchyQoL）和皮肤病生活质量指数（POEM）问卷，并被要求使用10分制的瘙痒峰值数字评定量表（NRS）对瘙痒严重程度进行评分。通过湿疹面积和严重程度指数（EASI）和医师整体评估特应性皮炎（vIGA-AD）评估AD的严重程度。
平均年龄为29.68±12.87岁，56.0%的患者为白人。97.8%的患者目前正在经历瘙痒，平均NRS评分为7.32±2.22。患者伴有出血（71.4%）、热感（63.7%）和疼痛（54.9%）。加重因素包括压力（93.4%）、皮肤干燥（91.2%）和出汗（75.8%）。ItchyQoL总评分的平均值为78.93±17.20。女性性别与较高的ItchyQoL总评分显著相关（p = 0.009）。在调整模型中，颈部、足部和全身的瘙痒与较高的ItchyQoL总评分相关（p < 0.05）。EASI、vIGA-AD和POEM与瘙痒强度（r = 0.434、0.406和0.610）以及ItchyQoL总评分（r = 0.425、0.436和0.631）呈中度相关。
以白人为主的人群队列可能无法代表巴西患者群体中多样的AD表型。14岁以下儿童和65岁以上成年人被排除在人群队列之外。此外，纳入研究的患者可能患有其他导致瘙痒的非皮肤病，这可能会影响观察到的结果。
巴西的AD患者经历了严重的瘙痒，这影响了他们的生活质量。在评估有瘙痒症状的AD患者时，应考虑性别、瘙痒的身体部位、相关疼痛和压力等因素。
