Association of pruritus with quality of life and disability in systemic sclerosis

Abstract

Objective. To our knowledge, no studies have investigated the association of pruritus, which is present in almost half of patients with systemic sclerosis (SSc; scleroderma), with quality of life (QOL) and disability. The objective of this study was to investigate the association of pruritus with QOL and disability in SSc. Methods. We performed a cross-sectional, multicenter study of 578 SSc patients >1 year post-enrollment in the Canadian Scleroderma Research Group Registry. Patients reported whether they experienced pruritus during the past month on most days and underwent clinical histories and medical examinations. QOL was measured using the mental and physical component summary scores of the Short Form 36, and disability was measured with the Health Assessment Questionnaire disability index. The association of pruritus with QOL and disability was estimated using linear regression, controlling for sociodemographic and disease variables. Results. A total of 248 patients (43%) reported pruritus on most days. Patients with pruritus had significantly worse mental (Hedges's g ‫؍‬ ؊0.43; 95% confidence interval [95% CI] ؊0.59, ؊0.26) and physical function (Hedges's g ‫؍‬ ؊0.51; 95% CI ؊0.68, ؊0.34) and greater disability (Hedges's g ‫؍‬ 0.46; 95% CI 0.29, 0.63) than patients without pruritus. In multivariate analyses, controlling for age, sex, marital status, education, disease duration, skin score, number of tender joints, gastrointestinal symptoms, breathing problems, Raynaud's phenomenon, and finger ulcers, pruritus was independently associated with mental (P ‫؍‬ 0.017) and physical function (P ‫؍‬ 0.003), but not disability (P ‫؍‬ 0.112). Conclusion. Pruritus is common and associated with QOL in SSc. More attention to pruritus in SSc is needed, including its measurement, etiology, trajectory, and potential methods for intervention.

Clinical characteristics of itch in cutaneous lupus erythematosus: A prospective, multicenter, multinational, cross-sectional study

“…No other study or review to our knowledge has comprehensively investigated and characterized itch in CLE patients. We found a high prevalence of pruritus among CLE patients (77.1%) with a higher rate than that reported in the majority of available studies involving patients suffering from ACTDs with prominent cutaneous features, such as SLE (45%), 9 systemic sclerosis (42.6% to 62%), 10 , 27 , 28 and clinically amyopathic dermatomyositis (55%). 29 Notably, the results hereby presented are in concordance with our prior findings of high prevalence of itching (75%) in CLE subjects which was demonstrated on a larger population of 567 patients.…”

Itch and systemic sclerosis: frequency, clinical characteristics and consequences

“…This study is the first study to use a specific itch-related QoL measure tool because previous studies used general tools. 9,10 We show that the impact on QoL is quite important. Most often, physicians do not sufficiently take pruritus into consideration, because patients have numerous comorbidities, but it is a frequent symptom that impairs QoL.…”

Dermatology life quality index in Thai patients with systemic sclerosis: A cross-sectional study

“…The first study which investigated correlation of pruritus and QoL and disability was done by the Canadian Scleroderma Research Group. [4] That study showed that pruritus in SSc was common and had significant association with mental and physical function but not disability. Concerning clinical presentations, salt and pepper appearance seemed to have more significant impact on the patients than other skin manifestations (P<0.05).…”