Clinical Characteristics Of Pruritus And Its Impact On Quality Of Life Among Patients With Psoriasis

Objective:To investigate the prevalence and clinical characteristics of pruritus among patients with psoriasis, to compare the effect on the quality of life between psoriasis and pruritus. Methods:This study was conducted by 51 cases psoriasis inpatients and outpatients at dermatological department in the First Hospital of Shanxi Medical University from September 2014 to January 2015. After the informed consent of the patients and their families, a structured psoriasis itch questionnaire of our own design was given to these patients. The questionnaire included four aspects: general condition of patients(age, sex, height, weight, education level, obstetrical history, etc.), pruritus(with or without itching, itching of course, the nature, frequency, intensity(VAS score, 5D scale score), location, aggravating and mitigating factors, etc.), psoriasis conditions(psoriasis type, family history, disease duration, disease site, PASI(Psoriasis Area and Severity Index scale), etc.), as well as the quality of life of patients reflect by DLQI scale(Dermatology life quality index scores). Finally, all data were entered Excel, Statistical analyses were done using simple descriptions and frequencies of various factors, one-way ANOVA, rank-sum test,The independent samples t-test, and Pearson correlation analysis by the SPSS 22.0 program. Results:The 51 cases of psoriasis patients, 12 cases were excluded due to other complications, effective rate 76.47%, 39 cases of psoriasis patients included in the study, 35 cases(89.7%) accompanied by itching, and the type of psoriasis are vulgaris. The average degree of itching was moderate: VAS score: mean 4.43 ± 2.22, median 4; 5D itch scale score: mean 11.37 ± 3.15, median 11; 10 cases(28.57%) with mild itching, 25 cases(71.43%) with severe itching. 16 patients with acute pruritus(45.7%), 19 cases(54.3%) with chronic pruritus. The main areas of pruritus: back(57.1%), scalp(45.7%), lower leg(45.7%) and forearm(40%); itching aggravated time: at night(82.1%), all day(11.1%); The most- IV-common descriptions of itching: stinging(48.6%), crawling(20%), burning(14.3%). Aggravating factors of pruritus: dry skin(45.8%), pressure(37.5%), mood(37.5%), sweating(33.3%); relieve factors of itching: rest / vacation(50%), bath + Run skin(37.5%), scratching(25%). Pruritus intensity as reflected by a Visual analogue scale and the 5D itch scale did not correlate with Body Mass Index. However, Pruritus intensity were significantly positive correlated with psoriasis duration(VAS score: r = 0.406, P = 0.015<0.05, R2 = 0.165; 5D Scale score: r =0.338, P =0.047<0.05, R2 =0.114) and Dermatology life quality index scores(VAS score: r =0.683, P =0.000<0.05, R2= 0.467;5D Scale score: r =0.539, P =0.001<0.05, R2 = 0.291) and Psoriasis area and Severity index scores(VAS score: r =0.432, P =0.009<0.05, R2 =0.186; 5D Scale score: r =0.569, P =0.000<0.05, R2 =0.324). A highly significant positive correlation was obtained between Psoriasis area and Severity index scores and Dermatology life quality index scores(r =0.438, P =0.009<0.05, R2 =0.191). There was no significant difference between the two groups(acute and chronic itching) in terms of DLQI(P=0.306>0.05) and Pruritus intensity(P = 0.955> 0.05). Multiple linear regression analysis of vas(X1), PASI(X2) and DLQI(Y), the standardized regression coefficient(b1,=0.626, b2,=0.108): the order of the DLQI effect sizes: VAS, PASI. The stepwise method in analysis shows: the DLQI change and vas have a linear regression relationship(P < 0.001), and PASI was removed(P = 0.475 > 0.1) Conclusion:1. Pruritus is the most common symptoms of psoriasis, the majority of psoriasis patients along with moderate to severe pruritus.2. Pruritus aggravated mainly at night or in winter; the most commonly affected sites were back, scalp, lower legs and forearms. Major aggravating factors for pruritus were dryness of skin, stress, mood, sweating, break / vacation, bath + emollient and scratching could relieve pruritus.3. Among pruritus patients with psoriasis, the pruritus degree was serious in older patients than in young patients, and lower quality of life than the young patients; Male patients have longer duration of pruritus.4. Pruritus intensity was significantly positive correlates with psoriasis duration or PASI. The longer the course of psoriasis is, the heavier the degree of pruritus is, the more severe the itching will be.5. Pruritus was greater impact on the quality of life.