Pruritus burden in psoriasis patients

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This study looked at the significance of chronic pruritus for intrapersonal burden and interpersonal experiences of stigmatization and sexuality in patients with psoriasis.

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Background:
60–90 % of patients with psoriasis suffer from pruritus and 65 % report itching as one of the most burdensome symptoms, raising significant quality of life (QoL) impairments. However, pruritus is not only an intrapersonal symptom but also a psychosocial interactive phenomenon and little is known about the effects of itching on interpersonal experiences.

Objectives:
This study aimed to compare the disease burden and patient needs between patients with none/mild vs. moderate/severe pruritus, and to examine the impact of disease parameters and intrapersonal burden on perceived stigmatization and sexual relationships.

Methods:
This cross‐sectional study included German patients aged ≥ 18 years with psoriasis vulgaris. Disease severity was assessed with PASI (Psoriasis Area and Severity Index); patients reported on intensity of pruritus, skin‐generic and pruritus‐specific QoL, patient needs and benefits, anxiety and depression symptoms, dysmorphic concerns, perceived stigmatization and sexual dysfunction.

Results:
107 patients with psoriasis participated (mean age = 46.3 ± 14.6 years; 52.3 % male): 64 with none/mild pruritus (NRS ≤ 3) and 43 with moderate/severe pruritus (NRS ≥ 4). Patients with moderate/severe pruritus reported more QoL impairments, depression and anxiety symptoms and dysmorphic concerns, but less treatment benefits, than those with none/mild pruritus. The patient needs most frequently rated as “very/quite important“ were: “be healed of all skin defects“ (88.8 %), and “be free of itching“ (87.0 %), with no differences between the groups. Younger age, disease severity, frequency of scratching behaviors, dysmorphic concerns and treatment benefits were positively associated with stigmatization experiences; disease severity, sleeping problems and skin‐generic QoL impairments were positively associated with sexual dysfunction.

Conclusions:
Pruritus induces significant burden in patients with psoriasis. Along with disease severity, intrapersonal burden has a great impact on social and dyadic relationships. Treatment choices that are effective in reducing pruritus should be prioritized in patient‐centered healthcare.

Source: onlinelibrary.wiley.com

*Early view funding unknown