M P Pereira1, S Steinke1, C Zeidler1, C Forner1, C Riepe1, M Augustin2, S Bobko3, F Dalgard4, J Elberling5, S Garcovich6, U Gieler7, M Gonçalo8, J A Halvorsen9, T A Leslie10, M Metz11, A Reich12, E Şavk13, G Schneider14, E Serra-Baldrich15, H F Ständer16, M Streit17, J Wallengren18, K Weller11, A Wollenberg19, P Bruland20, I Soto-Rey20, M Storck20, M Dugas20, E Weisshaar21, J C Szepietowski22, F J Legat23, S Ständer1. 1. Department of Dermatology, Competence Center for Chronic Pruritus, University Hospital Münster, Münster, Germany. 2. Competence Center for Healthcare Research in Dermatology (CVderm), Institute for Healthcare Research in Dermatology and Nursing (IVDP), University Hospital of Hamburg-Eppendorf, Hamburg, Germany. 3. Moscow Scientific and Practical Center of Dermatovenerology and Cosmetology, Moscow, Russia. 4. Department of Dermatology and Venereology, Skåne University Hospital, Lund University, Malmö, Sweden. 5. Department of Dermatology, University Hospital Gentofte, Copenhagen, Denmark. 6. Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy. 7. Justus Liebig University, Giessen, Germany. 8. Department of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal. 9. Department of Dermatology, Oslo University Hospital, University of Oslo, Oslo, Norway. 10. Department of Dermatology, Royal Free Hospital, London, UK. 11. Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany. 12. Department of Dermatology, University of Rzeszow, Rzeszow, Poland. 13. Department of Dermatology, Adnan Menderes University, Aydın, Turkey. 14. Department of Psychosomatics and Psychotherapy, Münster University Hospital, Münster, Germany. 15. Department of Dermatology, Cutaneous Allergy Unit, Hospital Sant Pau, Universitat Autònoma Barcelona, Barcelona, Spain. 16. Dermatological Practice, Bad Bentheim and Department of Dermatology, Klinikum Dortmund GmbH, Dortmund, Germany. 17. Department of Dermatology, Kantonsspital Aarau, Aarau, Switzerland. 18. Department of Dermatology and Venereology, Skåne University Hospital SUS Lund, Lund University, Lund, Sweden. 19. Department of Dermatology and Allergology, Ludwig Maximilian University, Munich, Germany. 20. Institute of Medical Informatics, University of Münster, Münster, Germany. 21. Department of Social Medicine, Occupational and Environmental Dermatology, University of Heidelberg, Heidelberg, Germany. 22. Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland. 23. Department of Dermatology, Medical University of Graz, Graz, Austria.
Abstract
BACKGROUND: The term prurigo has been used for many decades in dermatology without clear definition, and currently used terminology of prurigo is inconsistent and confusing. Especially, itch-related prurigo remains unexplored regarding the epidemiology, clinical profile, natural course, underlying causes, available treatments and economic burden, although burdensome and difficult to treat. OBJECTIVE: To address these issues, the multicentre European Prurigo Project (EPP) was designed to increase knowledge on chronic prurigo (CPG). In the first step, European experts of the EADV Task Force Pruritus (TFP) aimed to achieve a consensus on the definition, classification and terminology of CPG. Additionally, procedures of the cross-sectional EPP were discussed and agreed upon. METHODS: Discussions and surveys between members of the TFP served as basis for a consensus conference. Using the Delphi method, consensus was defined as an agreement ≥75% among the present members. RESULTS: Twenty-four members of the TFP participated in the consensus conference. Experts consented that CPG should be used as an umbrella term for the range of clinical manifestations (e.g. papular, nodular, plaque or umbilicated types). CPG is considered a distinct disease defined by the presence of chronic pruritus for ≥6 weeks, history and/or signs of repeated scratching and multiple localized/generalized pruriginous skin lesions (whitish or pink papules, nodules and/or plaques). CPG occurs due to a neuronal sensitization to itch and the development of an itch-scratch cycle. CONCLUSION: This new definition and terminology of CPG should be implemented in dermatology to harmonize communication in the clinical routine, clinical trials and scientific literature. Acute/subacute forms of prurigo are separated entities, which need to be differentiated from CPG and will be discussed in a next step. In the near future, the cross-sectional EPP will provide relevant clinical data on various aspects of CPG leading to new directions in the scientific investigation of CGP.
BACKGROUND: The term prurigo has been used for many decades in dermatology without clear definition, and currently used terminology of prurigo is inconsistent and confusing. Especially, itch-related prurigo remains unexplored regarding the epidemiology, clinical profile, natural course, underlying causes, available treatments and economic burden, although burdensome and difficult to treat. OBJECTIVE: To address these issues, the multicentre European Prurigo Project (EPP) was designed to increase knowledge on chronic prurigo (CPG). In the first step, European experts of the EADV Task Force Pruritus (TFP) aimed to achieve a consensus on the definition, classification and terminology of CPG. Additionally, procedures of the cross-sectional EPP were discussed and agreed upon. METHODS: Discussions and surveys between members of the TFP served as basis for a consensus conference. Using the Delphi method, consensus was defined as an agreement ≥75% among the present members. RESULTS: Twenty-four members of the TFP participated in the consensus conference. Experts consented that CPG should be used as an umbrella term for the range of clinical manifestations (e.g. papular, nodular, plaque or umbilicated types). CPG is considered a distinct disease defined by the presence of chronic pruritus for ≥6 weeks, history and/or signs of repeated scratching and multiple localized/generalized pruriginous skin lesions (whitish or pink papules, nodules and/or plaques). CPG occurs due to a neuronal sensitization to itch and the development of an itch-scratch cycle. CONCLUSION: This new definition and terminology of CPG should be implemented in dermatology to harmonize communication in the clinical routine, clinical trials and scientific literature. Acute/subacute forms of prurigo are separated entities, which need to be differentiated from CPG and will be discussed in a next step. In the near future, the cross-sectional EPP will provide relevant clinical data on various aspects of CPG leading to new directions in the scientific investigation of CGP.
Authors: Hideyuki Ujiie; David Rosmarin; Michael P Schön; Sonja Ständer; Katharina Boch; Martin Metz; Marcus Maurer; Diamant Thaci; Enno Schmidt; Connor Cole; Kyle T Amber; Dario Didona; Michael Hertl; Andreas Recke; Hanna Graßhoff; Alexander Hackel; Anja Schumann; Gabriela Riemekasten; Katja Bieber; Gant Sprow; Joshua Dan; Detlef Zillikens; Tanya Sezin; Angela M Christiano; Kerstin Wolk; Robert Sabat; Khalaf Kridin; Victoria P Werth; Ralf J Ludwig Journal: Front Med (Lausanne) Date: 2022-06-09
Authors: Manuel P Pereira; Claudia Zeidler; Joanna Wallengren; Jon Anders Halvorsen; Elke Weisshaar; Simone Garcovich; Laurent Misery; Emilie Brenaut; Ekin Şavk; Nikolay Potekaev; Andrey Lvov; Svetlana Bobko; Jacek C Szepietowski; Adam Reich; Agnieszka Bozek; Franz J Legat; Martin Metz; Markus Streit; Esther Serra-Baldrich; Margarida Gonçalo; Michael Storck; Teresa Nau; Vincent Hoffmann; Sabine Steinke; Ina Greiwe; Martin Dugas; Matthias Augustin; Sonja Ständer Journal: Acta Derm Venereol Date: 2021-02-17 Impact factor: 3.875