The burden in chronic prurigo: patients with chronic prurigo suffer more than patients with chronic pruritus on non-lesional skin.

BACKGROUND Chronic prurigo (CPG) is known as a high burdensome disease characterized by severe pruritus and multiple pruriginous lesions. Interestingly, the disease specific burden is not well established and there are no data which compare the impact of CPG with chronic pruritus (CP) on non-lesional skin (CP-NL). OBJECTIVES To address this issue, we analyzed datasets from 4,484 patients with either CPG or CP-NL. METHODS Demographic, medical data and additional information collected by validated patient reported outcome tools were analyzed. The visual analogue scale and numerical rating scale (NRS) was used for assessing the pruritus intensity, the ItchyQoL for patients' quality of life, the Hospital Anxiety and Depression Scale and the Patient Needs Questionnaire' as a part of Patient Benefit Index for Pruritus for measuring the importance of 27 patient needs in terms of treatment goals. The Neuroderm questionnaire was used to assess the history of pruritus characteristics and the impact on sleep. RESULTS Patients with CPG suffered longer and with a higher intensity from pruritus (NRS worst the last 24h, CPG 6.0 [4.0;8.0] vs. CP-NL 3.0 [5.0;7.0], p<0.001). In them, pruritus occurred more often and the whole day and night which led to more loss in sleeping hours (CPG 3.0 hours [2.0;4.0] vs. CP-NL 2.0 hours [1.0;4.0], p<0.001). Patients with CPG showed higher scores for depression (HADS-D, CPG 6.0 [3.0;10.0] vs. CP-NL 5.0 [2.0;8.0], p<0.001), more impaired quality of life (ItchyQol; CPG: 72.6 [61.6;83.6] vs. CP-NL 59.4 [48.4;70.4], p<0.001) and higher weighted needs in the predefined treatment goals. DISCUSSION Not only the presence of severe pruritus and pruriginous lesions but also sleep disorders and other mental symptoms may contribute to a higher burden in patients with CPG when compared with patients with CP-NL.