M P Pereira1, V Hoffmann1, E Weisshaar2, J Wallengren3, J A Halvorsen4, S Garcovich5, L Misery6, E Brenaut6, E Savk7, N Potekaev8, A Lvov8, S Bobko8, J C Szepietowski9, A Reich10, A Bozek11, F J Legat12, M Metz13, M Streit14, E Serra-Baldrich15, M Gonçalo16, M Storck17, I Greiwe1, T Nau1, S Steinke1, M Dugas17, S Ständer1, C Zeidler1. 1. Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany. 2. Occupational Medicine, Department of Dermatology, University of Heidelberg, Heidelberg, Germany. 3. Department of Clinical Sciences Lund, Dermatology and Venereology and Skane University Hospital, Lund, Sweden. 4. Department of Dermatology, Oslo University Hospital, University of Oslo, Oslo, Norway. 5. Institute of Dermatology, F. Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy. 6. Department of Dermatology, University Hospital of Brest, Brest, France. 7. Department of Dermatology, Aydin Adnan Menderes University, Aydın, Turkey. 8. Moscow Scientific and Practical Center of Dermatovenerology and Cosmetology, Moscow, Russia. 9. Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland. 10. Department of Dermatology, University of Rzeszów, Rzeszów, Poland. 11. Department of Dermatology, School of Medicine, University of Information Technology and Management, Rzeszow, Poland. 12. Department of Dermatology, Medical University of Graz, Graz, Austria. 13. Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany. 14. Department of Dermatology, Kantonsspital Aarau, Aarau, Switzerland. 15. Department Dermatology, Sant Pau Hospital, Barcelona, Spain. 16. Department of Dermatology, University Hospital and Faculty of Medicine, University of Coimbra, Coimbra, Portugal. 17. Institute of Medical Informatics, University of Münster, Münster, Germany.
Abstract
BACKGROUND: Chronic nodular prurigo (CNPG) is a condition characterized by chronic itch, a prolonged scratching behaviour and the presence of pruriginous nodules. A comprehensive understanding of this condition, especially regarding its clinical characteristics and impact on quality of life is still lacking. OBJECTIVES: Aim of this pan-European multicentre cross-sectional study was to establish the clinical profile of CNPG, including its associated burden. METHODS: Fifteen centres from 12 European countries recruited CNPG patients presenting at the centre or using the centres' own databases. Patients were asked to complete a questionnaire in paper or electronic format. Demography, current co-morbidities, underlying disease, itch intensity, additional sensory symptoms, quality of life, highest burden and emotional experience of itch were assessed. RESULTS: A total of 509 patients (210 male, median age: 64 years [52; 72]) were enrolled. Of these, 406 reported itch and CNPG lesions in the previous 7 days and qualified to complete the whole questionnaire. We recorded moderate to severe worst itch intensity scores in the previous 24 h. Scores were higher in patients with lower educational levels and those coming from Eastern or Southern Europe. Most patients experience itch often or always (71%) and report that their everyday life is negatively affected (53%). Itch intensity was considered to be the most burdensome aspect of the disease by 49% of the patients, followed by the visibility of skin lesions (21%) and bleeding of lesions (21%). The majority of patients was unaware of an underlying condition contributing to CNPG (64%), while psychiatric diseases were the conditions most often mentioned in association with CNPG (19%). CONCLUSIONS: This multicentre cross-sectional study shows that itch is the dominant symptom in CNPG and reveals that the profile of the disease is similar throughout Europe.
BACKGROUND: Chronic nodular prurigo (CNPG) is a condition characterized by chronic itch, a prolonged scratching behaviour and the presence of pruriginous nodules. A comprehensive understanding of this condition, especially regarding its clinical characteristics and impact on quality of life is still lacking. OBJECTIVES: Aim of this pan-European multicentre cross-sectional study was to establish the clinical profile of CNPG, including its associated burden. METHODS: Fifteen centres from 12 European countries recruited CNPG patients presenting at the centre or using the centres' own databases. Patients were asked to complete a questionnaire in paper or electronic format. Demography, current co-morbidities, underlying disease, itch intensity, additional sensory symptoms, quality of life, highest burden and emotional experience of itch were assessed. RESULTS: A total of 509 patients (210 male, median age: 64 years [52; 72]) were enrolled. Of these, 406 reported itch and CNPG lesions in the previous 7 days and qualified to complete the whole questionnaire. We recorded moderate to severe worst itch intensity scores in the previous 24 h. Scores were higher in patients with lower educational levels and those coming from Eastern or Southern Europe. Most patients experience itch often or always (71%) and report that their everyday life is negatively affected (53%). Itch intensity was considered to be the most burdensome aspect of the disease by 49% of the patients, followed by the visibility of skin lesions (21%) and bleeding of lesions (21%). The majority of patients was unaware of an underlying condition contributing to CNPG (64%), while psychiatric diseases were the conditions most often mentioned in association with CNPG (19%). CONCLUSIONS: This multicentre cross-sectional study shows that itch is the dominant symptom in CNPG and reveals that the profile of the disease is similar throughout Europe.
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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