Itch in patients with cutaneous T-cell lymphoma as a quality of life indicator

Reply to Correspondence to “Itch in patients with cutaneous T-cell lymphoma as a quality of life indicator”

“…To the Editor: First of all, we thank Joshi and Duvic 1 for their critical review and reaction of our paper regarding itching and the quality of life (QoL) in patients with cutaneous T-cell lymphoma. 2 This will help us to gain more attention for this underexposed subject in cutaneous lymphoma research.…”

Understanding itch in cutaneous T-cell lymphoma: Exploring the impact of comorbidities, treatment regimens, and racial differences on quality of life

“…To the Editor: We read with interest the paper by Ottevanger et al, 1 which explores the impact of itch on the quality of life (QoL) of patients with cutaneous T-cell lymphoma (CTCL). The investigators show pruritus to have a significant impact on the QoL of patients with CTCL.…”

“…To adjust for comorbidities as a potential confounder, the authors use the Charlson comorbidity index to quantify the burden of comorbid disease. 1 Although the Charlson comorbidity index is a validated tool to account for comorbid diseases, it fails to capture important comorbidities present in patients with CTCL. Recently, we have shown mycosis fungoides to be significantly associated with inflammatory bowel disease, hypothyroidism, and vitiligo—important autoimmune illnesses not considered by the Charlson comorbidity index.…”

“…Recently, we have shown mycosis fungoides to be significantly associated with inflammatory bowel disease, hypothyroidism, and vitiligo—important autoimmune illnesses not considered by the Charlson comorbidity index. 3 Additionally, the authors further characterize the comorbidity burden as low (0-1 comorbidities) and high (≥2 comorbidities) 1 ; however, such a stratification fails to account for the fact that certain comorbidities may have a more pronounced impact on QoL. Vitiligo, for instance, is associated with significant psychosocial morbidity, and the presence of vitiligo alone may bear a more negative QoL burden than the sum of other comorbidities.…”

“…Another important limitation of the analysis by Ottevanger et al 1 is that the investigators do not describe which treatments, if any, the patients were undergoing during the study; however, certain treatments for CTCL are known to mitigate pruritis. For example, the histone deacetylase inhibitors romidepsin and vorinostat have been shown to blunt pruritus not just in responders but also in nonresponders.…”