Evaluation of the presence of pruritus and its effect on quality of life

Objectives: Psoriasis is a chronic inflammatory disease that significantly affects the quality of life in psoriasis patients. Although psoriasis is not considered in classical itchy skin diseases, in recent years, the itch aspect of psoriasis has been drawing attention. The purpose of this study was to examine the presence of itching and it's features, to investigate relationship between pruritus features including especially severity and spesific disease characteristics and explore how pruritus affects the quality of life in plaque psoriasis patients. Methods: This study was conducted between March 2015 and September 2015 in the Department of Dermatology of the University of Karadeniz Technical University. A total of 100 psoriasis patients were included. The disease severity was assessed by Psoriasis Area and Severity Index (PASI), the pruritus was assessed by Visual Analogue Scale (VAS), The Worst Itch Numeric Rating Scale (Wı-Nrs) and Yosipovitch Itch Scale, the quality of life was assessed by Psoriasis Quality of Life Questionnaire (PQLQ) and Psoriasis Disability Index (PDI). Results: Of 100 patients with psoriasis, 73 (73%) suffered from pruritus. Patients who reported pruritus have higher mean PDI and PQLQ scores than patients who reported no pruritus (p=0,001, p=0,001). PDI and PQLQ scores were significantly higher in the patients that reported large pruritus surface area (p<0,001) (p<0,001). PDI scores scores were significantly higher in the patients that reported high level of their current pruritus (VAS3) than others (p=0,015). PDI and PQLQ scores were significantly higher in the patients that reported high level of the worst pruritus in the last 24 hours (WI-NRS) than others (p<0,001, p<0,001). In patients that have moderate-severe disease (PASI≥10), VAS3, VAS4, WI-NRS, PDI, and PQLQ scores significantly higher than patients that have mild disease (PASI <10) (p=0.002, p=0.045, p<0.001, p<0.001, p<0.001, respectively). Conclusion: The present study show that the quality of life is significantly impaired in psoriasis patients that reported pruritus and higher disease severity. In the light of these findings, the management of psoriasis should target not only skin and joint but also pruritus that reported frequently by psoriasis patients.