Significance of chronic pruritus for intrapersonal burden and interpersonal experiences of stigmatization and sexuality in patients with psoriasis. (29th March 2021)

• Record Type: Journal Article
• Authors: Sommer, R.; Augustin, M.; Hilbring, C.; Ständer, S.; Hubo, M.; Hutt, H.J.; von Stülpnagel, C.C.; da Silva, N.
• Is Part Of: Journal of the European Academy of Dermatology and Venereology. Volume 35:Number 7(2021)
• Page Start: 1553
• Page End: 1561
• Publication Date: 2021-03-29
• Subjects: Dermatology -- Periodicals; Sexually transmitted diseases -- Periodicals; 616.5
• DOI: 10.1111/jdv.17188
• Languages: English
• ISSNs: 0926-9959

Abstract

Abstract: Background: 60–90% of patients with psoriasis suffer from pruritus and 65% report itching as one of the most burdensome symptoms, raising significant quality of life (QoL) impairments. However, pruritus is not only an intrapersonal symptom but also a psychosocial interactive phenomenon and little is known about the effects of itching on interpersonal experiences. Objectives: This study aimed to compare the disease burden and patient needs between patients with none/mild vs. moderate/severe pruritus, and to examine the impact of disease parameters and intrapersonal burden on perceived stigmatization and sexual relationships. Methods: This cross‐sectional study included German patients aged ≥ 18 years with psoriasis vulgaris. Disease severity was assessed with Psoriasis Area and Severity Index; patients reported on intensity of pruritus, skin‐generic and pruritus‐specific QoL, patient needs and benefits, anxiety and depression symptoms, dysmorphic concerns, perceived stigmatization and sexual dysfunction. Results: A total of 107 patients with psoriasis participated (mean age = 46.3 ± 14.6 years; 52.3% male): 64 with none/mild pruritus (NRS ≤ 3) and 43 with moderate/severe pruritus (NRS ≥ 4). Patients with moderate/severe pruritus reported more QoL impairments, depression and anxiety symptoms and dysmorphic concerns, but less treatment benefits, than those with none/mild pruritus. The patient needs most frequently rated as 'very/quite important' were 'be healed of all skin defects' (88.8%), and 'be free of itching' (87.0%), with no differences between the groups. Younger age, disease severity, frequency of scratching behaviours, dysmorphic concerns and treatment benefits were positively associated with stigmatization experiences; disease severity, sleeping problems and skin‐generic QoL impairments were positively associated with sexual dysfunction. Conclusions: Pruritus induces significant burden in patients with psoriasis. Along with disease severity, intrapersonal burden has a great impact on social and dyadic relationships. Treatment choices that are effective in reducing pruritus should be prioritized in patient‐centred healthcare. Abstract : Linked commentary : J. Kupfer et al. J Eur Acad Dermatol Venereol 2021; 35: 1418–1419. https://doi.org/10.1111/jdv.17299 .