Acta Dermato-Venereologica 99-2CompleteContent | Page 10

146 CLINICAL REPORT Occurrence, Chronicity and Intensity of Itch in a Clinical Consecutive Sample of Patients with Skin Diseases: A Multi-centre Study in 13 European Countries Christina SCHUT 1 , Florence J. DALGARD 2,3 , Jon A. HALVORSEN 4 , Uwe GIELER 5 , Lars LIEN 3,6 , Lucia TOMAS ARAGONES 7 , Francoise POOT 8 , Gregor B. E. JEMEC 9 , Laurent MISERY 10,11 , Lajos KEMÉNY 12 , Francesca SAMPOGNA 13 , Henriët VAN MIDDENDORP 14 , Flora BALIEVA 15 , Dennis LINDER 16 , Jacek C. SZEPIETOWSKI 17 , Andrey LVOV 18 , Servando E. MARRON 19 , İlknur K. ALTUNAY 20 , Andrew Y. FINLAY 21 , Sam SALEK 22 and Jörg KUPFER 1 Institute of Medical Psychology, Justus-Liebig-University, Gießen, Germany, 2 Department of Dermatology and Venereology, Skåne University Hospital, Lund University, Malmö, Sweden, 3 Innlandet Hospital Trust, National Center for Dual Diagnosis, Brumundal, Norway, 4 Department of Dermatology, Oslo University Hospital, University of Oslo, Institute of Clinical Medicine, Oslo, Norway, 5 Justus-Liebig-University Giessen, Giessen, Germany, 6 Department of Public Health, Hedmark University College, Elverum, Norway, 7 Department of Psychology, Faculty of Education University of Zaragoza, Aragon Health Sciences Institute (IACS), Zaragoza, Spain, 8 Department of Dermatology, University Hospital Erasme, Brussels, Belgium, 9 Department of Dermatology, Zealand University Hospital, Roskilde, Health Sciences Faculty, University of Copenhagen, Copenhagen, Denmark, 10 Department of Dermatology, University Hospital of Brest, 11 Laboratory of Neurosciences, University of Western Brittany, Brest, France, 12 Department of Dermatology and Allergology, MTA-SZTE Dermatological Research Group, University of Szeged, Szeged, Hungary, 13 Clinical Epidemiology Unit, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy, 14 Health, Medical and Neuropsychology unit, Faculty of Social and Behavioural Sciences, Leiden University, Leiden, The Netherlands, 15 Department of Dermatology, Stavanger University Hospital, Stavanger, 16 Section of Biostatistics, University of Oslo, Oslo, Norway, 17 Department of Dermatology, Venereology and Allergology, Wrocław Medical University, Wroclaw, Poland, 18 Department of Clinical Dermatology and Cosmetology, Moscow Scientific and Practical Center of Dermatovenereology and Cosmetology, Moscow, Russia, 19 Dermatology Department, Royo Villanova Hospital, Aragon Health Sciences Institute (IACS), Zaragoza, Spain, 20 Dermatology and Venereology Clinic, University of Health Sciences, Istanbul Sişli Hamidiye Etfal Health Training and Research Center, Şişli – Istanbul, Turkey, 21 Dermatology and Academic Wound Healing, Division of Infection and Immunity, Cardiff University School of Medicine, College of Biomedical and Life Sciences, Cardiff, and 22 School of Life and Medical Sciences, University of Hertfordshire, College Lane, Hatfield, UK 1 Itch is an unpleasant symptom, affecting many der- matological patients. Studies investigating the occur- rence and intensity of itch in dermatological patients often focus on a single skin disease and omit a control group with healthy skin. The aim of this multi-centre study was to assess the occurrence, chronicity and in- tensity (visual analogue scale 0–10) of itch in patients with different skin diseases and healthy-skin controls. Out of 3,530 dermatological patients, 54.3% reported itch (mean  ±  standard deviation itch intensity 5.5  ±  2.5), while out of 1,094 healthy-skin controls 8% had itch (3.6  ±  2.3). Chronic itch was reported by 36.9% of the patients and 4.7% of the healthy-skin controls. Itch was most frequent (occurrence rates higher than 80%) in patients with unclassified pruritus, prurigo and related conditions, atopic dermatitis and hand ec- zema. However, many patients with psychodermato- logical conditions and naevi also reported itch (occur- rence rates higher than 19%). Key words: itch occurrence; itch intensity; itch chronicity; skin diseases; European perspective. Accepted Sep 18, 2018; E-published Sep 18, 2018 Acta Derm Venereol 2019; 99: 146–151. Corr: Christina Schut, Institute of Medical Psychology, Justus-Liebig- University Gießen, Klinikstraße 29, DE-35392 Gießen, Germany. E-mail: [email protected] T he Global Burden of Disease Study 2010 (1) esti- mated that 33.7 million years lived with disability (YLD) are caused by skin and subcutaneous diseases. According to this study, which analysed data from 187 countries, skin conditions represent “the fourth leading cause of nonfatal disease burden” (2), affecting 1.9 bil- doi: 10.2340/00015555-3040 Acta Derm Venereol 2019; 99: 146–151 SIGNIFICANCE This European multi-centre study investigated the occur- rence, chronicity and intensity of itch in a large sample of outpatients with different skin diseases and healthy- skin controls. In this study 54.3% of patients and 8% of healthy-skin controls had itch at the time of investigation. Chronic itch was reported by 36.9% of patients and 4.7% of healthy-skin controls. The mean itch intensity in pa- tients was 5.5  ±  2.5 (on a scale from 0–10) compared with 3.6  ±  2.3 in healthy-skin controls. Thus, itch is a very com- mon, intense symptom among dermatological outpatients for which better specific therapies are needed. lion people at any time (2, 3). Itch, defined by Hafenreffer as “an unpleasant cutaneous sensation that provokes the desire to scratch” (4) has long been neglected and unre- cognized, even though it represents a common symptom in patients with skin diseases (5–7). Thus, there is a need to better document itch in patients with skin disease in order to encourage the development of new treatments, allocate resources more appropriately and develop better care for patients with itch. The distribution and burden of itch in dermatological patients is mainly known from single-centre studies (8, 9) or studies focusing on a single skin disease (e.g. 10, 11). Also, studies on the occurrence of itch are often uncontrolled (8–12). Recently, the European Society for Dermatology and Psychiatry (ESDaP) completed a large European observational cross-sectional multi-centre study to better document the psychological burden (i.e. anxiety and depression, negative life events and suicidal ideation) of patients with skin disease (13). In this study, patients This is an open access article under the CC BY-NC license. www.medicaljournals.se/acta Journal Compilation © 2019 Acta Dermato-Venereologica.