Itch in psoriasis: epidemiology, clinical aspects and treatment options

Abstract

BackgroundPruritus is an important symptom in psoriasis vulgaris, may be severe and seriously affect the quality of life of patients, but published data on its frequency and characteristics are limited.ObjectiveThe study objective was to characterize the prevalence of itch in psoriatic patients and the effect of treatment modalities by using a comprehensive itch questionnaire of own design.MethodsA structured itch questionnaire was given to 90 patients with moderate to severe chronic-plaque psoriasis selected consecutively from the patients visiting the Department of Dermatology of the University of Florence. The questionnaire concerned the areas involved psoriasis and pruritus, the pruritus characteristics, the worsening and relieving factors and treatment modalities. Itch intensity was reflected by a 10 point visual analog scale (VAS) and the degree of symptoms discriminated between mild (1–3), moderate (4–7) and severe (8–10).ResultsAlmost 85% of psoriatic patients suffered from itching; the frequency of pruritus was daily and mean intensity by VAS scale was moderate. Presence and intensity of pruritus and body mass index (BMI) were correlated. 40% of patients with pruritus were overweight (BMI > 25 < 30) and 10% obese (BMI > 30). Almost all patients appeared unsatisfied with the available treatment modalities for pruritus in psoriasis. Emollients, topical steroids and calcipotriol cream could relieve pruritus but their effect was temporary. Among the antipsoriatic therapies, phototherapy with narrow band ultraviolet B (nb-UVB) was the most effective treatment in reducing pruritus. Biological therapies, mainly etanercept and efalizumab, proved useful in its control.ConclusionsThe questionnaire was a useful tool to characterize itch, and the results might help us to better understand pruritus in psoriasis. The results confirmed the need for a global study of psoriasis with regard to both the cutaneous manifestations and the itch symptom.

Psoriasis, a Systemic Disease Beyond the Skin, as Evidenced by Psoriatic Arthritis and Many Comorbities – Clinical Remission with a Leishmania Amastigotes Vaccine, a Serendipity Finding

“…85% of psoriatic patients suffered from itching; the frequency of pruritus was daily and mean intensity was moderate. The results confirmed the need for a global study of psoriasis with regard to both the cutaneous manifestations and the itch symptom (Prignano et al, 2009). Ophthalmic complications of psoriasis are numerous and affect almost any part of the eye; however, they may be easily missed.…”

Scalp Itch: A Systematic Review

“…Itch is present in 67-97% of patients with psoriasis [13][14][15][16][17][18] . Specifically, scalp itch has been reported in up to 80% of patients with psoriasis, and there is positive correlation between the severity of the lesions in scalp psoriasis and the severity of itch [19] .…”

The relationship between pruritus and the clinical signs of psoriasis in patients receiving tofacitinib

“…However, current therapies have been shown to be largely ineffective, with a substantial proportion of patients reporting dissatisfaction with available treatment options (9).…”