When life is an itch: What harms, helps and heals from the patients' perspective? Differences and similarities among skin diseases

Itch is the commonest skin-related symptom, associated with a high psychosocial and economic burden. While the main focus of itch research lies on a few chronic skin diseases, only little is known about the perception of itch, itch-aggravating/-relieving factors and treatment preferences in patients with acute and chronic itch of various etiology. In this cross-sectional study we assessed these aspects in 126 patients (mean age 61.7 ±18.4 years, 67 females, median itch duration 3.9 years) using a 78-item questionnaire. The diseases were categorised into 11 diagnostic groups for descriptive analysis, the three most frequent groups ("Atopic dermatitis"; "Non-atopic eczema"; "Inflammatory dermatoses") were statistically compared. Itch was most often perceived as localised 42.9%, burning (40.5%) and worrying (39.7%) with worsening in the evening (49.2%), due to warmth (42.1%) and sweating (26.2%). Whilst itch perception, itch-aggravating factors and treatment preferences differed broadly amongst patients, the itch-relieving personal strategies were more uniform ("scratching by hand 70.6%, applying topicals 57.9%). 69.8% of patients suffered from itch-related sleep disturbance, consequently affecting their relatives in 30.0%. Subgroup comparisons revealed significant differences regarding itch-aggravating factors (p=0.0012) and itch duration (p=0.0082). Patients rated the antipruritic effectiveness of phototherapy, "Complementary & alternative medicine" and "Other tablets" as high, but oral antihistamines, "Cortisone tablets" and any topical as only moderately efficacious. The preferred administration of an ideal itch treatment was "Creams/ointments" (51.6%) or "Tablets" (35.7%), only few patients preferred "injections" or "patches". Consideration of such differences and similarities in itch characteristics and treatment preferences could help to better tailor treatment in itch patients. This article is protected by copyright. All rights reserved.