- Il presente studio trasversale ha incluso 634 pazienti e 246 controlli sani per valutare le caratteristiche e l’impatto del prurito in una coorte di pazienti con psoriasi provenienti da Germania, Polonia e Russia.
- Il prurito ha un’alta prevalenza nella psoriasi e si associa a un forte impatto sul paziente; le terapie attuali sono spesso insufficienti per controllare tale sintomo.
- Una corretta gestione della malattia dovrebbe includere la valutazione e il controllo del prurito e dovrebbero essere sviluppate terapie efficaci.
Abstract
Background
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.
Objective
To investigate characteristics and burden of pruritus in an international cohort of patients with psoriasis.
Methods
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.
Results
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.
Conclusions and perspectives
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.