When life is an itch: What harms, helps, and heals from the patients' perspective? Differences and similarities among skin diseases

Abstract

Itch is the commonest skin‐related symptom, associated with a high psychosocial and economic burden. While the main focus of itch research lies on a few chronic skin diseases, only little is known about the perception of itch, itch‐aggravating/‐relieving factors and treatment preferences in patients with acute and chronic itch of various etiology. In this cross‐sectional study we assessed these aspects in 126 patients (mean age 61.7 ±18.4 years, 67 females, median itch duration 3.9 years) using a 78‐item questionnaire. The diseases were categorised into 11 diagnostic groups for descriptive analysis, the three most frequent groups (“Atopic dermatitis”; “Non‐atopic eczema”; “Inflammatory dermatoses”) were statistically compared. Itch was most often perceived as localised 42.9%, burning (40.5%) and worrying (39.7%) with worsening in the evening (49.2%), due to warmth (42.1%) and sweating (26.2%). Whilst itch perception, itch‐aggravating factors and treatment preferences differed broadly amongst patients, the itch‐relieving personal strategies were more uniform (“scratching by hand 70.6%, applying topicals 57.9%). 69.8% of patients suffered from itch‐related sleep disturbance, consequently affecting their relatives in 30.0%. Subgroup comparisons revealed significant differences regarding itch‐aggravating factors (p=0.0012) and itch duration (p=0.0082). Patients rated the antipruritic effectiveness of phototherapy, “Complementary & alternative medicine” and “Other tablets” as high, but oral antihistamines, “Cortisone tablets” and any topical as only moderately efficacious. The preferred administration of an ideal itch treatment was “Creams/ointments” (51.6%) or “Tablets” (35.7%), only few patients preferred “injections” or “patches”. Consideration of such differences and similarities in itch characteristics and treatment preferences could help to better tailor treatment in itch patients.