Cross‐European validation of the ItchyQoL in pruritic dermatoses

Zeidler, Claudia; Steinke, Sabine; Riepe, Claudia; Bruland, Philipp; Soto-Rey, Iñaki; Storck, Michael; Garcovich, Simone; Blome, Christine; Bobko, S.; Legat, Franz J.; Потекаев, Н. Н.; Lvov, A. N.; Miséry, Laurent; Weger, Wolfgang; Reich, Adam; Şavk, Ekin; Streit, Markus; Serra‐Baldrich, E.; Szepietowski, Jacek C.; Yosipovitch, Gil; Chen, Shuo; Dugas, Martin; Ständer, Sonja

doi:10.1111/jdv.15225

Cited by 35 publications

(31 citation statements)

References 16 publications

(58 reference statements)

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“…17 In terms of skin-related (DLQI) and itch-related (ItchyQoL) impairment of quality of life our population was also within the range of previous studies. 19 However, in contrast to previous studies, 20,21 the level of anxiety and depression (as measured by the HADS-A/D) was not increased in our population. This difference may be explained by the fact that we did not only include patients with chronic itch-which is known to be associated with anxiety and depression [20][21][22] but also patients with acute itch, which may have had only minor negative effects on psychological wellbeing so far.…”

Section: Discussioncontrasting

confidence: 99%

Itch reduction using immersive virtual reality—An experimental pilot study

Baschong

Spieß

Cattin

et al. 2021

Dermatologic Therapy

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In a previous proof-of-concept study we have demonstrated that visual exposure to specific colors results in pruritic or antipruritic effects. To determine the effect of "antipruritic" colors when using immersive virtual reality (VR) and to assess whether psychometric values correlate with the response to the color exposure. In this crosssectional interventional single-center study, itch patients were exposed to their subjective "antipruritic color" (defined by the Manchester Color Wheel) in a virtual monochromatic room for 10 min using a head-mounted display. Itch intensity rating (0-10 numerical rating scale [NRS]) was repeated at 1-min intervals. Additionally, dermatology life quality index, itch-related quality of life and the Hospital Anxiety and Depression Scale questionnaires were completed. Twenty-two patients (mean age 51.9 ± 23 years, 13 females) participated in the study. Following color exposure for 10 min itch intensity was significantly reduced compared to baseline (exact Wilcoxon signed-rank test, mdn-NRS 4.5 vs 3.0; z = À3.025, p = 0.001), confirmed by the area under the curve (z = À3.118; p = 0.001). No significant correlation between itch reduction and questionnaire scores was found (Spearman's Rho for all questionnaires). Visual exposure to the "antipruritic color" using immersive VR resulted in a significant decrease in itch intensity. This aligns with previous findings on the influence of colors on itch perception. The response of the intervention appeared independent of psychometric values. Thus, color exposure using immersive VR is a promising, low-cost, rapidly-acting, easily-applicable, non-pharmacological experimental antipruritic method. K E Y W O R D S antipruritic, colors, itch, pruritus, virtual reality 1 | INTRODUCTION "Quod pruritus […] sit tristis sensatio, desiderium scalpendi excitans […]" 1 -The itch […], is [this] unpleasant sensation which elicits the desire to scratch […]. This first definition of itch proposed byHafenreffer in 1660 still holds true to today. 2 Itch (synonymous pruritus) is the commonest skin-related symptom caused by numerous dermatological and non-dermatological conditions. [3][4][5] Chronic pruritus, defined as itch lasting over 6 weeks, has a substantial burden of disease and a negative impact on quality of life comparable to that of chronic pain. 6 Treatment of itch is often challenging and unsatisfactory for several reasons such as involvement of various itch mediators (e.g., psoriasis), 7 multifactorial itch causes in a single patient (e.g., iron deficiency, chronic kidney disease, xeroderma, drugs), latency of the treatment effect (e.g., antipruritic antidepressants, antiinflammatory treatment), lack of evidence (e.g., treatment of pruritus

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Section: Discussioncontrasting

confidence: 99%

Itch reduction using immersive virtual reality—An experimental pilot study

Baschong

Spieß

Cattin

et al. 2021

Dermatologic Therapy

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“…The highest burden associated with the disease was the itch, which was described as disturbing (55.2%), burdensome (50.7%) or agonizing (46.6%) by a substantial number of patients and has been shown to contribute substantially to psychological disease burden 21 . Accordingly, the impairment of the quality of life correlated with itch intensity, as observed for other pruritic diseases 22 . Other aspects of the disease such as the visibility of the skin lesions and bleeding from the lesions were also mentioned as the highest burden, but only by a minority of the patients (14–21%) and thus seem to play a secondary role for patients.…”

Section: Discussionmentioning

confidence: 87%

Chronic nodular prurigo: clinical profile and burden. A European cross‐sectional study

Pereira

Hoffmann

Weißhaar

et al. 2020

Acad Dermatol Venereol

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Background Chronic nodular prurigo (CNPG) is a condition characterized by chronic itch, a prolonged scratching behaviour and the presence of pruriginous nodules. A comprehensive understanding of this condition, especially regarding its clinical characteristics and impact on quality of life is still lacking. Objectives Aim of this pan-European multicentre cross-sectional study was to establish the clinical profile of CNPG, including its associated burden. Methods Fifteen centres from 12 European countries recruited CNPG patients presenting at the centre or using the centres' own databases. Patients were asked to complete a questionnaire in paper or electronic format. Demography, current co-morbidities, underlying disease, itch intensity, additional sensory symptoms, quality of life, highest burden and emotional experience of itch were assessed. Results A total of 509 patients (210 male, median age: 64 years [52; 72]) were enrolled. Of these, 406 reported itch and CNPG lesions in the previous 7 days and qualified to complete the whole questionnaire. We recorded moderate to severe worst itch intensity scores in the previous 24 h. Scores were higher in patients with lower educational levels and those coming from Eastern or Southern Europe. Most patients experience itch often or always (71%) and report that their everyday life is negatively affected (53%). Itch intensity was considered to be the most burdensome aspect of the disease by 49% of the patients, followed by the visibility of skin lesions (21%) and bleeding of lesions (21%). The majority of patients was unaware of an underlying condition contributing to CNPG (64%), while psychiatric diseases were the conditions most often mentioned in association with CNPG (19%). Conclusions This multicentre cross-sectional study shows that itch is the dominant symptom in CNPG and reveals that the profile of the disease is similar throughout Europe.

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“…As in our study we have analyzed only dermatological patients with pruritus concomitant to skin disorders, we have decided to evaluate QoL impairment with DLQI because this scale is widely used giving the possibility to compare our results with other authors, consists of only 10 questions, and the QoL impairment categories are well-defined. However, when assessing other pruritus subtypes, ItchyQol, an itch-specific QoL measure, would probably be more suitable (13). Nevertheless, it was shown, that DLQI scoring is strongly correlated with ItchyQol scoring (14), suggesting that at least in dermatological condition both scales may be used interchangeably and the use of DLQI in group of patients should not be considered as detrimental.…”

Section: Discussionmentioning

confidence: 99%

The 12-Item Pruritus Severity Scale – Determining the Severity Bands

Stępień

Reich

2020

Front. Med.

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Introduction: Assessment of pruritus still remains a challenge due to its subjective character. Various itch questionnaires are widely used to evaluate the severity of pruritus. The aim of the current study was to define the cut off values for the 12-Item Pruritus Severity Scale (12-PSS).Methods: A total of 240 patients (86 males and 154 females) in the age between 19 and 87 years (mean 52.9 ± 20.7 years) suffering from pruritic dermatological conditions were asked to assess their maximal pruritus with the 12-PSS, the Verbal Rating Scale (VRS) and the Numerical Rating Scale (NRS). All subjects also completed the Dermatology Life Quality Index (DLQI). VRS, NRS, and DLQI scorings were used as anchor measures to define cut-offs of 12-PSS.Results: According to VRS, 43 (17.9%) patients suffered from mild, 96 (40%) from moderate, 65 (27.1%) from severe and 36 (15%) from very severe pruritus. Mean 12-PSS scoring for each VRS category was 7.6 ± 3.9, 10.4 ± 3.9, 13.0 ± 3.8, and 13.9 ± 3.8 points, respectively (p < 0.001). Each VRS category significantly differed from the others regarding the mean 12-PSS scoring, except the mean scoring of severe and very severe pruritus (p = 0.72). Thus, three pruritus severity categories of 12-PSS were defined with following score ranges: mild pruritus−3–6 points of 12-PSS, moderate pruritus−7–11 points of 12-PSS and severe pruritus−12–22 points of 12-PSS based on calculation of weighted κ coefficient against VRS, NRS, and DLQI as anchor measures.Conclusions: The 12-PSS is able to differentiate between patients suffering from mild, moderate, and severe pruritus.

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Cross‐European validation of the ItchyQoL in pruritic dermatoses

Abstract: ItchyQoL is now also validated in French, Italian, Polish, Russian, Spanish and Turkish and can be used in clinical trials in countries speaking these languages.

Cited by 35 publications

References 16 publications

Itch reduction using immersive virtual reality—An experimental pilot study

Itch reduction using immersive virtual reality—An experimental pilot study

Chronic nodular prurigo: clinical profile and burden. A European cross‐sectional study

The 12-Item Pruritus Severity Scale – Determining the Severity Bands

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