Itch in Ethnic Populations

Abstract

Racial and ethnic differences in the prevalence and clinical characteristics of itch have rarely been studied. The aim of this review is to highlight possible associations between ethnicity and different forms of chronic itch. We provide a current review of the prevalence of different types of itch in ethnic populations. Genetic variation may significantly affect receptors for itch as well as response to anti-pruritic therapies. Primary cutaneous amyloidosis, a type of pruritic dermatosis, is particularly common in Asians and rare in Caucasians and African Americans, and this may relate to a genetic polymorphism in the Interleukin-31 receptor. Pruritus secondary to the use of chloroquine for malaria is a common problem for African patients, but is not commonly reported in other ethnic groups. In patients with primary biliary cirrhosis, pruritus is more common and more severe in African Americans and Hispanics compared with Caucasians. Racial and ethnic differences in itch and its medical care are poorly understood. Research is needed to examine biological, psychosocial, and lifestyle factors that may contribute to these disparities.

Questionnaires to Assess Chronic Itch: A Consensus Paper of the Special Interest Group of the International Forum on the Study of Itch

“…Repeatibility variation in recording CI should be kept to minimum. The study of CI is complicated by multiple factors such as age, environment, level of education and literacy rate, social, cultural and psychological factors (10,22,23,30) (Fig. 1).…”

“…In particular, the impact of ethnicity on CI has received minimal attention. Itch intensity ratings are likely to differ between patients of varying ethnic and cultural backgrounds (30). Further, the distribution of underlying aetiologies causing CI varies substantially between countries (23).…”

Pain and itch outcome trajectories differ among European American and African American survivors of major thermal burn injury

“…Based on data from the National Burn Registry and the US Census data, African Americans are 1.5 times as likely to experience burn injury compared to European Americans [2; 8], and in other clinical settings African Americans have been shown to experience a greater burden of pain and itch relative to European Americans [14; 17; 50; 56]. Some of this disparity in pain and itch outcomes is likely due to the markedly greater socioeconomic disadvantage experienced by African Americans [25; 41; 64]; however, evidence from other health conditions characterized by chronic pain and/or itch suggests that differences in health outcomes between African Americans and European Americans may not be due to socioeconomic differences alone [46; 52; 56; 64].…”

“…Some of this disparity in pain and itch outcomes is likely due to the markedly greater socioeconomic disadvantage experienced by African Americans [25; 41; 64]; however, evidence from other health conditions characterized by chronic pain and/or itch suggests that differences in health outcomes between African Americans and European Americans may not be due to socioeconomic differences alone [46; 52; 56; 64]. …”

Itch pathophysiology may differ among ethnic groups

“…In view of the growing populations of immigrants in both Western Europe and the USA, it is important to acknowledge the existence of significant differences in skin physiology. Research has shown different prevalences of itch as a symptom in different ethnic groups, and data show that differing levels of clinical importance are placed upon itch across ethnicities 1 . In Norway, healthy male immigrants from East Asia, the Middle East, and North Africa report the presence of itch significantly more frequently than Norwegians and immigrants from Western countries 2 .…”