Gender differences in chronic pruritus: women present different morbidity, more scratch lesions and higher burden

Ständer, Sonja; Stumpf, Astrid; Osada, Nani; Wilp, S.; Chatzigeorgakidis, E.; Pfleiderer, Bettina

doi:10.1111/bjd.12267

Cited by 106 publications

(116 citation statements)

References 42 publications

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“…Women also have more neuropathic and somatic symptom disorders (DSM V), underlying their chronic pruritus than males [6] . We found that females' itch ratings were higher than males for itch-related pictures, particularly in response to skin contact (torso, arms, and legs) and skin condition (torso only) images indicating possible sex differences in empathic judgements [15] .…”

Section: Discussionmentioning

confidence: 99%

“…Although recent studies have shown sexspecific differences in the quality, localization and triggering of chronic pruritus, and in the underlying disease and scratching behavior [6] , studies from the experimental literature have typically found no sex differences in itch contagion [3] , itch ratings or scratch behavior [1] . However, this may be due to limited sample sizes (eg, only 3 males and 8 females with AD were tested in Papoiu et al [1] ) or biased samples that recruited twice as many females to males [3] .…”

Section: Introductionmentioning

confidence: 99%

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Are sex and history of pruritic skin conditions factors which affect the phenomenon of visually evoked itch? An exploratory study

Lloyd¹,

Dodd²,

Higgins³

et al. 2017

Itch

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Introduction:We have previously shown that sensations of itch and the scratch response can be evoked using itch-related images. However, we did not determine whether individual differences in a person's experience of itch could moderate this effect. This exploratory study aimed to determine whether sex or a history of pruritic skin conditions (PSCs) could influence the effects of visually evoked itch and scratch. Methods: Forty-one participants (19 males; 16 with a history of PSCs) viewed static images that could either be itch or nonitch related. These were further separated by picture type: "skin contact" (ants crawling on the hand vs. a butterfly on the finger); "skin response" (scratching an insect bite vs. washing the hands); "skin condition" (psoriasis vs. freckles) or "context only" (insects vs. birds). Images were rated using a 10-point scale by answering: "How itchy do you feel?" (Self-rating) and "How itchy do you think the person in the picture feels?" (Other-rating). Frequency and location of scratching was also recorded. Results: The highest itch scores were to itch-related skin contact pictures. Females gave higher itch ratings than males, and people with a history of PSCs gave higher itch ratings when viewing images of people scratching. There was no correlation between itch ratings and scratch response, and no relationship between body site viewed and location of scratching. Discussion: There is a heightened response to itch-related cues in females and those with PSCs, indicating a more centrally mediated pathway bringing subconscious itch sensations into conscious awareness in these populations. These findings could influence personalized treatment interventions aimed at reducing awareness of itch sensations in susceptible individuals.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Are sex and history of pruritic skin conditions factors which affect the phenomenon of visually evoked itch? An exploratory study

Lloyd¹,

Dodd²,

Higgins³

et al. 2017

Itch

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“…Magerl et al (1990) (Ständer et al 2013;Stumpf et al 2013b;Stumpf et al 2014). Diese geschlechtsassoziierten Intensitätsunterschiede decken sich mit den Ergebnissen aus der Schmerzforschung.…”

Section: Geschlechtsspezifi Sche Physiologische Unterschiede In Der Punclassified

“…Stumpf et al (2013a) Frauen leiden nicht nur stärker unter dem Pruritus, anscheinend wird dieser bei Frauen auch vermehrt durch psychische Faktoren getriggert bzw. geht vermehrt mit psychischen Symptomen wie Angst und Depression einher (Ständer et al 2013;Stumpf et al 2014; siehe Tab. 1).…”

Section: Geschlechtsspezifi Sche Psychische Unterschiedeunclassified

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Geschlechtsspezifische Unterschiede bei chronischem Pruritus

Stumpf¹,

Ständer²,

Zeidler³

et al. 2015

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"Chronischer Juckreiz ist mit einer Lebenszeitprävalenz von ca. 23 % ein sehr häufiges Symptom, das durch zahlreiche dermatologische, internistische, neurologische und auch psychische Erkrankungen ausgelöst werden kann. Während bei jüngeren Patientinnen und Patienten eher der entstellende Aspekt der durch Kratzen beschädigten Haut eine Rolle spielt, leiden ältere Patientinnen und Patienten oftmals unter einem schwer zu behandelbaren Juckreiz unterschiedlichster Ursache. Obwohl der chronische Pruritus als Volkssymptom angesehen werden kann, liegen bisher nur sehr wenige Studien zu geschlechtsspezifischen Unterschieden vor. Diese zeigen, dass Frauen und Männer eine unterschiedliche Pruritus- Wahrnehmung haben - Frauen nehmen das Symptom intensiver wahr. Dies führt bei Frauen nicht nur zu einer höheren psychischen Belastung, sondern auch zu einem unterschiedlichen Verhalten - Frauen kratzen vermehrt. Aber auch die Qualitäten des Symptoms sind unterschiedlich, Frauen empfinden beispielsweise vermehrt einen brennenden Juckreiz, was u. a. auf die Aktivierung von schmerzleitenden Nervenfasern (neuropathische Komponente) hindeutet. Dies deutet auf eine unterschiedliche Verarbeitung von Pruritus im Gehirn hin. Die geschlechtsspezifischen Unterschiede hinsichtlich der Juckempfindung sollten dringend weiter untersucht werden, um eine geschlechtsadaptierte Diagnostik und möglicherweise auch Therapie anbieten zu können und somit zur verbesserten Behandlung der Betroffenen beitragen zu können." (Autorenreferat)"Chronicitch is a common symptom with a life-time prevalence of around 23% which is provoked by numerous dermatological, internal, neurological and mental disorders. While the disfiguring resulting from skin being damaged by scratching plays an important role in younger patients, older patients often suffer from a difficult-to-treat pruritus of various causes. Although chronic pruritus can be considered as a widespread disease, there are only a few studies which have examined sex-/ gender-specific differences. These studies have indicated that females and males have a different pruritus perception: females experience the symptom more intensively. This not only leads to a greater psychological burden in females, but results in a different behaviour, because females scratch more. Women also experience different symptoms, for example more women experience a burning itch, which indicates a stronger involvement of nerve fibres (neuropathic component). Women not only experience greater itch intensity, they are also more distracted by the itching than men are. This indicates a different cerebral perception and modulation. Sex-/genderspecific differences in regard to itching need further investigation in order to be able to offer sex-/gender-specific diagnostics and tailor therapy to improve the clinical situation of the affected patients." (Autorenreferat

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