Itch in skin of colour: a multicentre cross‐sectional study

Sutaria, Nishadh; Parthasarathy, V.; Roh, Youkyung S.; Choi, Justin; Bordeaux, Zachary A.; Trinh, Pavin; Le, Thomas K.; Semenov, Yevgeniy R.; Kwatra, Shawn G.

doi:10.1111/bjd.20403

Cited by 9 publications

(5 citation statements)

References 8 publications

(14 reference statements)

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“…Limited data exist relating ethnicity to VLP, although Ingafou and colleagues demonstrated the majority of their 690 patient cohort with OLP were Caucasian (68.7%), although our proportion of Caucasian patients was higher with 91% overall 12 . Sutaria and colleagues found chronic pruritus in Black and Asian patients were associated with an increased likelihood of LP, with ORs of 1.19 (95% CI 1.12–1.26) and 1.28 (95% CI 1.12–1.45), respectively, compared with White patients 13 . Further epidemiological studies spanning multiple centres would reveal the extent to which ethnicity and VLP severity are associated.…”

Section: Discussionmentioning

confidence: 65%

“…The AUC for the ROC curve is 0.77, indicating moderate predictive ability and colleagues chronic pruritus Black and patients were associated with an increased likelihood of LP, with ORs of 1.19 (95% CI 1.12-1.26) and 1.28 (95% CI 1.12-1.45), respectively, compared with White patients. 13 Further epidemiological studies spanning multiple centres would reveal the extent to which ethnicity and VLP severity are associated.…”

Section: Discussionmentioning

confidence: 99%

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Identifying predictors of systemic immunosuppressive treatment of vulvovaginal lichen planus: A retrospective cohort study of 122 women

Kherlopian

Fischer

2022

Aust J Dermatology

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Background Between 20% and 40% of women with vulvovaginal lichen planus (VLP) fail to respond to first‐line ultra‐potent topical corticosteroid treatment and require systemic immunosuppression to control disease. No data exist regarding risk factors for patients with severe VLP requiring systemic immunosuppression. We aimed to identify clinical features that predict women with VLP who are at risk of severe, recalcitrant disease requiring eventual escalation to systemic treatment. Methods A chart review was performed on a cohort of 122 adult women with VLP followed prospectively for 15 years by the same clinician in a private dermatology practice in Australia between 1 January 2004 and 1 October 2021. Uni‐ and multivariable binary logistical regression analyses were performed to identify clinical features distinguishing women eventually requiring systemic treatment of VLP against those whose VLP was controlled with topical corticosteroids alone. Results The mean age at diagnosis of VLP was 61 years, with 35 women (28.7%) requiring systemic treatment of VLP. A multivariable regression model utilising ‘Age at Diagnosis’ (adjusted OR = 0.97, 95% CI 0.94–0.99), ‘Non‐Caucasian Ethnicity’ (adjusted OR = 10.3, 95% CI 2.27–73.9) and ‘Vulvar Pruritus’ (adjusted OR = 2.69, 95% CI 1.11–6.86) demonstrated moderate predictive capacity, with specificity and sensitivity for predicting whether a patient will require systemic treatment for VLP of 95.3% and 40.5%, respectively. Conclusions Our findings may indicate women with VLP who are younger, of non‐Caucasian ethnicity, and presenting with vulval pruritus are the highest risk of severe disease requiring systemic immunosuppressive treatment and may benefit most from earlier initiation of systemic treatment.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Identifying predictors of systemic immunosuppressive treatment of vulvovaginal lichen planus: A retrospective cohort study of 122 women

Kherlopian

Fischer

2022

Aust J Dermatology

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“…Whang et al reported in a cross sectional study of 18,753 patients at Johns Hopkins Health System that patients seen for itch-related concerns were more likely to be Black (37%) compared to White (19%), and noted that these findings correlated with findings of larger national databases [5]. A multi-center cross-sectional study reported similar findings of a higher prevalence of chronic pruritus in Black individuals compared with other racial groups [6].…”

Section: Introductionmentioning

confidence: 83%

Prevalence of Chronic Pruritus in Elderly Black and White Inpatients: A Comparative Population Study

Mahmoud,

Choragudi,

Nwaopara

et al. 2023

JCM

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Background: Black and geriatric patients were reported in small scale studies to have more intense chronic pruritus (CP). Studies comparing itch across geriatric racial groups are lacking. Objectives: To compare the prevalence of CP in Black and White inpatients ≥ 65 years old as well as the top primary diagnoses of these populations. Methods: We used data from the National Inpatient Sample from 2016–2019 to analyze CP prevalence and ICD10-CM to identify diseases. The top five primary diagnoses were calculated for a subpopulation with CP. Sample characteristics were described, and the data was pooled and analyzed using IBM SPSS® Complex Sample modules. Results: Among hospitalized Black inpatients ≥ 65 years old, the prevalence of CP was 0.26% while in the White cohort it was 0.22%. The top five primary diagnoses in the Black population with itch were sepsis (4.2%); hypertensive heart and chronic kidney disease (CKD) with heart failure (HF) and stage 1–4 CKD, or unspecified CKD (4.1%); acute kidney failure (4.0%); hypertensive heart and CKD with HF with stage 5 CKD, or end-stage renal disease (2.1%); and hypertensive heart disease with HF (1.7%). The top five primary diagnoses in the White population were sepsis (4.25%); acute kidney failure (3.0%); hypertensive heart and CKD with HF and stage 1–4 CKD, or unspecified CKD (2.5%); cellulitis of left lower limb (1.9%); and unilateral primary osteoarthritis, right knee (1.9%). Conclusions: Geriatric hospitalized Black patients demonstrated a higher prevalence of chronic itch compared with the White cohort, which may be related to the higher prevalence of chronic kidney disease in different stages of severity in this population.

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“…A limitation of this analysis is measuring itch in only the previous 3 days, as is done in SCORAD, because itch in AD is chronic and long-lasting. The data were obtained in a single country not resembling cultural and ethnic aspects of itch ( 32 ). It remains to be seen if these results will be confirmed, for example in TARGET-DERM AD study, a longitudinal cohort study that plans to include 4,000 patients with AD in up to 100 clinical centres in the USA ( 33 ).…”

Section: Discussionmentioning

confidence: 99%

Itching in Atopic Dermatitis: Patient- and Physician-reported Outcomes in the German Atopic Dermatitis Registry TREATgermany

et al. 2023

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TREATgermany is an investigator-initiated prospective disease registry. It investigates physician- and patient-reported disease severity (Eczema Area and Severity Index (EASI), objective Scoring Atopic Dermatitis (oSCORAD), Investigator Global Assessment, Patient-Oriented Eczema Measure (POEM), Patient Global Assessment (PGA)), patient-reported symptoms (itch, sleep loss, depressive symptoms), therapy courses and dermatological quality of life (DLQI) in moderate-to-severe atopic dermatitis with SCORAD > 20. 1,134 atopic dermatitis patients (mean age 41.0 ± 14.7 years, 42.5% females) were enrolled by 40 German recruiting sites (dermatological clinics and practices) between June 2016 and April 2021. The current analysis focuses on itch scores obtained with a numerical rating scale (NRS)) documented for the previous 3 days prior to baseline visit. The results show that 97.2% (1,090 of 1,121) patients experienced itch. Itch severity correlated moderately with severity of atopic dermatitis oSCORAD (rho = 0.44 (0.39–0.48)) and EASI score (rho = 0.41 (0.36–0.46)). A strong correlation was found with self-reported disease severity as PGA (rho = 0.68 (0.65–0.71)), POEM sum score (rho = 0.66 (0.63–0.69)) and dermatological quality of life impairment DLQI (rho = 0.61 (0.57–0.65)). Itch as a subjective complaint is more closely correlated with patient-reported outcomes than with objective assessments by the physician.

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Itch in skin of colour: a multicentre cross‐sectional study

Cited by 9 publications

References 8 publications

Identifying predictors of systemic immunosuppressive treatment of vulvovaginal lichen planus: A retrospective cohort study of 122 women

Identifying predictors of systemic immunosuppressive treatment of vulvovaginal lichen planus: A retrospective cohort study of 122 women

Prevalence of Chronic Pruritus in Elderly Black and White Inpatients: A Comparative Population Study

Itching in Atopic Dermatitis: Patient- and Physician-reported Outcomes in the German Atopic Dermatitis Registry TREATgermany

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