Prevalence and Prediction of Prolonged Pruritus After Severe Burns

Abstract

Years after injury, pruritus is a common and severe problem for many burn patients. However, its characteristics and consequences are often only partially described. The authors therefore performed a prospective detailed examination of burn- and individual-related factors and considered those in relation to pruritus severity. Sixty-seven consecutive burn patients were assessed during acute care, and at 3 and 12 months postburn regarding preburn psychiatric disorders, health-related quality of life, post traumatic stress disorder, and personality traits. Postburn pruritus was subsequently assessed 2 to 7 years postburn using the Questionnaire for Pruritus Assessment. Fifty-one individuals, 76% of the participants, reported burn pruritus any time after the burn. Thirty-three individuals, 49% of the participants, reported ongoing pruritus the last 2 months. Information on the characteristics of pruritus was obtained from 32 of these individuals. Most perceived pruritus as bothersome or annoying and as present every day, 16 (50%) were considered to have severe pruritus, and 11 (34 %) scratched themselves to the point of bleeding. In logistic regressions, this was independently related to TBSA full-thickness burn and health-related quality of life at 3 months, and to TBSA full thickness burn and the personality trait impulsiveness, respectively. About half of the previous burn patients experienced ongoing pruritus on an average of 4.5 years after injury, and half of them had severe pruritus. Scratching oneself to the point of bleeding is linked both to a certain personality and to pruritus. It is suspected that many patients are left without access to the best available treatment.

Biotechnological Management of Skin Burn Injuries: Challenges and Perspectives in Wound Healing and Sensory Recovery

“…They revealed that more than two thirds of patients suffer from paresthesia, which the most frequent are tingling, stiffness, numbness or pinpricks (146,147). Itching is also a common post-burn paresthesia and affects at least 70% of burned patients at 1 or 2 years post-burn, and still around 40% in the following decade (12,148,149). The itching prevalence also depends on the injured anatomic sites.…”

Scalp Itch: A Systematic Review

“…They are included in this section for the purpose of clinical classification. Approximately 86% of patients with keloids have itch, which commonly affects the borders of keloid, and pruritus affects 76% of patients with burn lesions [62,63] . EPPER is a rare entity, which may present in the scalp when radiation has been used in this area.…”

Nerve reinnervation and itch behavior in a rat burn wound model

“…While differences in duration of scratching between sham‐treated and burn wound animals were highly significant, the average duration of scratching in burn wound animals (e.g., 46 second/hour in Week 6–12) is, in an absolute sense, not very impressive. Thus, the intensity of postburn itch in rats seems less debilitating than that described in humans . Nevertheless, this is the first time that increased scratching behavior is found in a burn wound animal model.…”

“…4 Complaints commonly start within one month postburn, with a peak at six months. 5 The prevalence of itch following burns is high: 6,7 up to 87% of the adults report mild to severe itching at three months postburn. 6 In 44% of the patients itch sensation was still present seven years postburn.…”