Pub Date : 2023-01-01DOI: 10.1097/itx.0000000000000068
Georgia Biazus Soares, O. Mahmoud, G. Yosipovitch
Chronic pain and chronic pruritus are both debilitating conditions that cause a significant burden to patients. Oxidative stress—driven by an imbalance between reactive oxygen species and antioxidants—has been shown to play a role both in pain disorders and conditions in which chronic itch is a prominent symptom. Antioxidants can be useful in treating oxidative stress-driven diseases and have shown promise in treating chronic pain conditions such as fibromyalgia and osteoarthritis. However, their role in treating pruritus and pruritic conditions such as psoriasis and atopic dermatitis remains unclear. Many of the current treatments for chronic itch are costly, associated with side effects, and have limited efficacy. Therefore, further controlled studies exploring antioxidants as a potential therapeutic option for chronic pruritus are warranted.
{"title":"Role of antioxidants in itch treatment: lessons learned from pain management","authors":"Georgia Biazus Soares, O. Mahmoud, G. Yosipovitch","doi":"10.1097/itx.0000000000000068","DOIUrl":"https://doi.org/10.1097/itx.0000000000000068","url":null,"abstract":"Chronic pain and chronic pruritus are both debilitating conditions that cause a significant burden to patients. Oxidative stress—driven by an imbalance between reactive oxygen species and antioxidants—has been shown to play a role both in pain disorders and conditions in which chronic itch is a prominent symptom. Antioxidants can be useful in treating oxidative stress-driven diseases and have shown promise in treating chronic pain conditions such as fibromyalgia and osteoarthritis. However, their role in treating pruritus and pruritic conditions such as psoriasis and atopic dermatitis remains unclear. Many of the current treatments for chronic itch are costly, associated with side effects, and have limited efficacy. Therefore, further controlled studies exploring antioxidants as a potential therapeutic option for chronic pruritus are warranted.","PeriodicalId":73523,"journal":{"name":"Itch (Philadelphia, Pa.)","volume":"8 1","pages":"e68 - e68"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43979778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-01DOI: 10.1097/itx.0000000000000061
C. Zeidler, M. Pereira, M. Storck, Aysenur Suer, S. Ständer
Introduction: Chronic nodular prurigo (CNPG) is a pruritic neuroinflammatory skin disease characterized by the presence of multiple pruriginous nodules. Previous psychometric analyzes showed the presence of moderate to severe pruritus and a considerable impairment of quality of life. A detailed study of these parameters in relation to the severity of the disease defined by the number of lesions is lacking. Methods: A total of 131 adult patients with CNPG were included. The number of pruriginous lesions and disease stage was determined by using the Prurigo Activity and Severity (PAS) scale and the prurigo-specific Investigator’s Global Assessment (IGA) scale. Patient-reported outcomes comprised pruritus intensity (worst itch intensity of the previous 24 h using the numerical rating scale; WI-NRS/24 h) and the impairment of quality of life (ItchyQol, Dermatology Life Quality Index; DLQI). Results: The counted and estimated number of pruriginous nodules correlated strongly with each other (r=0.82; P<0.001), moderately with the WI-NRS/24 h (counted number: r=0.44, P<0.001; estimated number: r=0.45, P<0.001) and with the DLQI score (counted number: r=0.40, P<0.001; estimated number: r=0.38, P<0.001). The severity groups of the CNPG, as defined by the IGA scale, correlated strongly with the WINRS/24 h and DLQI scores. With increasing severity of CNPG, increasing pruritus intensity and DLQI/ItchyQoL scores were recorded. Conclusion: The correlation between objective (disease stage) and subjective (itch intensity, quality of life) CNPG disease parameters argues for a representative disease severity characterization via physician assessments using either PAS or IGA.
{"title":"Severity stages of chronic nodular prurigo: analysis of associated itch intensity and quality of life impairment","authors":"C. Zeidler, M. Pereira, M. Storck, Aysenur Suer, S. Ständer","doi":"10.1097/itx.0000000000000061","DOIUrl":"https://doi.org/10.1097/itx.0000000000000061","url":null,"abstract":"Introduction: Chronic nodular prurigo (CNPG) is a pruritic neuroinflammatory skin disease characterized by the presence of multiple pruriginous nodules. Previous psychometric analyzes showed the presence of moderate to severe pruritus and a considerable impairment of quality of life. A detailed study of these parameters in relation to the severity of the disease defined by the number of lesions is lacking. Methods: A total of 131 adult patients with CNPG were included. The number of pruriginous lesions and disease stage was determined by using the Prurigo Activity and Severity (PAS) scale and the prurigo-specific Investigator’s Global Assessment (IGA) scale. Patient-reported outcomes comprised pruritus intensity (worst itch intensity of the previous 24 h using the numerical rating scale; WI-NRS/24 h) and the impairment of quality of life (ItchyQol, Dermatology Life Quality Index; DLQI). Results: The counted and estimated number of pruriginous nodules correlated strongly with each other (r=0.82; P<0.001), moderately with the WI-NRS/24 h (counted number: r=0.44, P<0.001; estimated number: r=0.45, P<0.001) and with the DLQI score (counted number: r=0.40, P<0.001; estimated number: r=0.38, P<0.001). The severity groups of the CNPG, as defined by the IGA scale, correlated strongly with the WINRS/24 h and DLQI scores. With increasing severity of CNPG, increasing pruritus intensity and DLQI/ItchyQoL scores were recorded. Conclusion: The correlation between objective (disease stage) and subjective (itch intensity, quality of life) CNPG disease parameters argues for a representative disease severity characterization via physician assessments using either PAS or IGA.","PeriodicalId":73523,"journal":{"name":"Itch (Philadelphia, Pa.)","volume":"7 1","pages":"e61 - e61"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47657189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.1097/itx.0000000000000060
Vishnutheertha Kulkarni, David Liu, P. Aggarwal, V. Gamsarian, A. Fleischer
Background: Itch is a symptom with significant physical, psychological, and financial burden worldwide. Symptom-specific and demographic risk factors have been published although community-level risk factors have not been thoroughly studied. Objectives: To describe the epidemiological risk factors of itch and to present a hypothesis that can account for these trends. Materials and methods: Itch incidence, prevalence, and years lost to disability (YLD) by age, sex, world region, socio-demographic index, percent of population using basic sanitation services, mortality due to air pollution, and gross domestic product (GDP) per capita were obtained from the University of Washington Institute for Health Metrics and Evaluation Global Burden of Disease (GBD), World Health Organization Global Health Observatory (WHO GHO), and Worldometer databases. Linear regression models were utilized to analyze the relationship of sanitation, air pollution, and GDP with itch incidence, prevalence and YLD. Results: Female sex and age were positively associated with higher incidence of itch. The percent of population using basic sanitation services was also positively correlated with itch incidence, prevalence, and YLD (P<0.001). Mortality rate due to air pollution was negatively associated with itch incidence, prevalence, and YLD (P<0.001). However, GDP per capita was not associated with the incidence (P=0.5), prevalence (P=0.8), and YLD (P=0.7) of itch. Conclusions: The “hygiene hypothesis” might explain global trends of itch as more industrialized countries have higher itch incidence rates. Thus, approaches which target molecular pathways involved in the “hygiene hypothesis” may lead to a decreased global itch burden.
{"title":"Global epidemiology of itch from 1990 to 2017: gender, age, sanitation, and air pollution as risk factors","authors":"Vishnutheertha Kulkarni, David Liu, P. Aggarwal, V. Gamsarian, A. Fleischer","doi":"10.1097/itx.0000000000000060","DOIUrl":"https://doi.org/10.1097/itx.0000000000000060","url":null,"abstract":"Background: Itch is a symptom with significant physical, psychological, and financial burden worldwide. Symptom-specific and demographic risk factors have been published although community-level risk factors have not been thoroughly studied. Objectives: To describe the epidemiological risk factors of itch and to present a hypothesis that can account for these trends. Materials and methods: Itch incidence, prevalence, and years lost to disability (YLD) by age, sex, world region, socio-demographic index, percent of population using basic sanitation services, mortality due to air pollution, and gross domestic product (GDP) per capita were obtained from the University of Washington Institute for Health Metrics and Evaluation Global Burden of Disease (GBD), World Health Organization Global Health Observatory (WHO GHO), and Worldometer databases. Linear regression models were utilized to analyze the relationship of sanitation, air pollution, and GDP with itch incidence, prevalence and YLD. Results: Female sex and age were positively associated with higher incidence of itch. The percent of population using basic sanitation services was also positively correlated with itch incidence, prevalence, and YLD (P<0.001). Mortality rate due to air pollution was negatively associated with itch incidence, prevalence, and YLD (P<0.001). However, GDP per capita was not associated with the incidence (P=0.5), prevalence (P=0.8), and YLD (P=0.7) of itch. Conclusions: The “hygiene hypothesis” might explain global trends of itch as more industrialized countries have higher itch incidence rates. Thus, approaches which target molecular pathways involved in the “hygiene hypothesis” may lead to a decreased global itch burden.","PeriodicalId":73523,"journal":{"name":"Itch (Philadelphia, Pa.)","volume":"7 1","pages":"e60 - e60"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46578706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.1097/itx.0000000000000062
M. Fujii, Shota Imahori, Misao Nakayama, T. Nabe, S. Ohya
Introduction: Itch (or pruritus) is a common symptom of atopic dermatitis (AD), which significantly decreases the patient’s quality of life. Tacrolimus ointment reduces pruritus in AD; however, the underlying mechanism is not fully understood. Methods: In the present study, we used a diet-induced AD mouse model to examine the antipruritic mechanism of tacrolimus. After induction of AD symptoms, the tacrolimus-containing ointment was applied once daily for 7 days. Responsiveness of isolated dorsal root ganglion (DRG) cells to various stimuli was examined by monitoring intracellular Ca2+ levels. Results: Repeated application of tacrolimus ointment attenuated spontaneous itch-related responses, even when skin barrier dysfunction, skin inflammation, and epidermal nerve sprouting were not ameliorated. Tacrolimus-treated mice also exhibited reduced scratching behavior induced by several pruritogens, such as histamine, SLIGRL-NH2, and chloroquine (CQ), although capsaicin-induced pain behavior was not affected. DRG cells from tacrolimus-treated mice showed significantly lower Ca2+ responses to CQ. Furthermore, a reduction in CQ-sensitive DRG neurons was observed after in vitro treatment with either tacrolimus or rapamycin. Discussion: CQ-sensitive (MrgprA3-expressing) DRG neurons are implicated as itch-specific sensory neurons. Therefore, topically applied tacrolimus may act directly on itch-signaling neurons, consequently suppressing various itch responses in AD mice.
{"title":"Tacrolimus suppresses itch-related response in diet-induced atopic dermatitis model mice by reducing chloroquine-sensitive sensory neurons","authors":"M. Fujii, Shota Imahori, Misao Nakayama, T. Nabe, S. Ohya","doi":"10.1097/itx.0000000000000062","DOIUrl":"https://doi.org/10.1097/itx.0000000000000062","url":null,"abstract":"Introduction: Itch (or pruritus) is a common symptom of atopic dermatitis (AD), which significantly decreases the patient’s quality of life. Tacrolimus ointment reduces pruritus in AD; however, the underlying mechanism is not fully understood. Methods: In the present study, we used a diet-induced AD mouse model to examine the antipruritic mechanism of tacrolimus. After induction of AD symptoms, the tacrolimus-containing ointment was applied once daily for 7 days. Responsiveness of isolated dorsal root ganglion (DRG) cells to various stimuli was examined by monitoring intracellular Ca2+ levels. Results: Repeated application of tacrolimus ointment attenuated spontaneous itch-related responses, even when skin barrier dysfunction, skin inflammation, and epidermal nerve sprouting were not ameliorated. Tacrolimus-treated mice also exhibited reduced scratching behavior induced by several pruritogens, such as histamine, SLIGRL-NH2, and chloroquine (CQ), although capsaicin-induced pain behavior was not affected. DRG cells from tacrolimus-treated mice showed significantly lower Ca2+ responses to CQ. Furthermore, a reduction in CQ-sensitive DRG neurons was observed after in vitro treatment with either tacrolimus or rapamycin. Discussion: CQ-sensitive (MrgprA3-expressing) DRG neurons are implicated as itch-specific sensory neurons. Therefore, topically applied tacrolimus may act directly on itch-signaling neurons, consequently suppressing various itch responses in AD mice.","PeriodicalId":73523,"journal":{"name":"Itch (Philadelphia, Pa.)","volume":"7 1","pages":"e62 - e62"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44980893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.1097/itx.0000000000000063
Jennifer M Becker, Sarah R. Vreijling, S. Van Damme, Elisa A. Kovacs, D. Veldhuijzen, A. Lavrijsen, D. V. Van Ryckeghem, G. Crombez, A. Evers, A. V. Van Laarhoven
Introduction: Attentional processes are involved in the experience of itch and pain. They interrupt task performance (ie, attentional interference) or bias allocation of attention toward the somatosensory stimulation, that is, attentional bias (AB). Research on AB toward pain is mostly focused on stimuli with short durations; hampering generalization to tonic pain sensations. Evidence for AB toward itch is lacking so far. This study investigated attentional interference by—and AB toward—experimentally induced tonic itch and pain. Methods: Fifty healthy volunteers performed a somatosensory attention task (SAT), that measured attentional interference and AB during tonic (35 s duration) pain, itch and vibrotactile stimuli. In addition, a dot-probe task measured AB toward visual representations of itch and pain, a Flanker task was used to assess attentional inhibition, and self-reported characteristics were measured. Results: Attentional interference during itch and pain stimuli compared with vibrotactile stimuli was found during the SAT. Exploration of shorter time segments within one tonic stimulus showed slowed responses for all three stimulus types during the first 5 seconds of stimulation. However, no prolonged interference in the following time segments was found. There was no AB toward somatosensory and visual stimuli. Furthermore, there was no association between any of the attentional measures and self-reported characteristics. Discussion: These findings suggest that the beginning of any somatosensory stimulus is interfering with cognitive performance, but the results for prolonged interference by itch and pain are equivocal. There was no indication for biased attention allocation. Whether this pattern is different in patients remains to be investigated in the future.
{"title":"Attentional interference, but no attentional bias, by tonic itch and pain stimulation","authors":"Jennifer M Becker, Sarah R. Vreijling, S. Van Damme, Elisa A. Kovacs, D. Veldhuijzen, A. Lavrijsen, D. V. Van Ryckeghem, G. Crombez, A. Evers, A. V. Van Laarhoven","doi":"10.1097/itx.0000000000000063","DOIUrl":"https://doi.org/10.1097/itx.0000000000000063","url":null,"abstract":"Introduction: Attentional processes are involved in the experience of itch and pain. They interrupt task performance (ie, attentional interference) or bias allocation of attention toward the somatosensory stimulation, that is, attentional bias (AB). Research on AB toward pain is mostly focused on stimuli with short durations; hampering generalization to tonic pain sensations. Evidence for AB toward itch is lacking so far. This study investigated attentional interference by—and AB toward—experimentally induced tonic itch and pain. Methods: Fifty healthy volunteers performed a somatosensory attention task (SAT), that measured attentional interference and AB during tonic (35 s duration) pain, itch and vibrotactile stimuli. In addition, a dot-probe task measured AB toward visual representations of itch and pain, a Flanker task was used to assess attentional inhibition, and self-reported characteristics were measured. Results: Attentional interference during itch and pain stimuli compared with vibrotactile stimuli was found during the SAT. Exploration of shorter time segments within one tonic stimulus showed slowed responses for all three stimulus types during the first 5 seconds of stimulation. However, no prolonged interference in the following time segments was found. There was no AB toward somatosensory and visual stimuli. Furthermore, there was no association between any of the attentional measures and self-reported characteristics. Discussion: These findings suggest that the beginning of any somatosensory stimulus is interfering with cognitive performance, but the results for prolonged interference by itch and pain are equivocal. There was no indication for biased attention allocation. Whether this pattern is different in patients remains to be investigated in the future.","PeriodicalId":73523,"journal":{"name":"Itch (Philadelphia, Pa.)","volume":"7 1","pages":"e63 - e63"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43650701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.1097/itx.0000000000000059
A. Hawash, L. Kapural, G. Yosipovitch
{"title":"Dorsal root ganglion neurostimulation: a target for treatment for intractable neuropathic itch?","authors":"A. Hawash, L. Kapural, G. Yosipovitch","doi":"10.1097/itx.0000000000000059","DOIUrl":"https://doi.org/10.1097/itx.0000000000000059","url":null,"abstract":"","PeriodicalId":73523,"journal":{"name":"Itch (Philadelphia, Pa.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48473397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.1097/itx.0000000000000051
Laura Hui, J. Lee, H. Tey
{"title":"Prurigo pigmentosa: a case with rapid response to doxycycline and the likely pathogenetic role of neutrophils","authors":"Laura Hui, J. Lee, H. Tey","doi":"10.1097/itx.0000000000000051","DOIUrl":"https://doi.org/10.1097/itx.0000000000000051","url":null,"abstract":"","PeriodicalId":73523,"journal":{"name":"Itch (Philadelphia, Pa.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43391476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.1097/itx.0000000000000052
C. Zeidler, M. Röchter, S. Ständer, M. Pereira
Introduction: The visual analogue scale (VAS), the numerical rating scale (NRS), and the verbal rating scale (VRS) are routinely used to assess pruritus intensity. However, these scales have limitations, especially the ceiling effect of linear scales (VAS, NRS) and the reduced sensitivity to change of the VRS. In the labeled magnitude scale (LMS) consisting of a vertical line with verbal anchors distributed quasi-logarithmically, the ceiling effect is reduced, allowing a higher discriminative assessment at the higher end of the scale. Methods: A total of 172 patients completed the LMS twice within 30–60 minutes to assess the reliability of the scale, as well as the NRS and VAS for analyses of convergent validity. Sensitivity to change of the LMS was investigated by analyzing changes in scores after a twice-daily application of an emollient containing menthoxypropanediol for 14 days. Results: Test-retest reliability was excellent for the LMS assessing average (Cronbach α: 0.955) and worst (Cronbach α: 0.945) pruritus intensity in the last 24 hours, while strong to very strong correlations were observed between the LMS and NRS assessing the worst (r=0.783) and average (r=0.808) pruritus intensity, respectively. Treatment with an emollient lead to a significant decrease in LMS scores (P<0.01). In patients with severe pruritus at baseline (VRS ≥3), we recorded a 30.2% improvement of average pruritus intensity using the LMS compared with a 25.0% improvement using the NRS and a 27.8% improvement of worst pruritus intensity using the LMS compared with an 11.1% improvement with the NRS. Most patients considered the LMS an appropriate instrument to assess pruritus intensity (89.6%) and would use it again (91.9%). Discussion: The LMS is an appropriate well-accepted instrument to assess CP. It is especially useful to detect variations in pruritus intensity in patients with severe CP.
{"title":"Validation of the labeled magnitude scale for the assessment of itch intensity in patients with chronic pruritus","authors":"C. Zeidler, M. Röchter, S. Ständer, M. Pereira","doi":"10.1097/itx.0000000000000052","DOIUrl":"https://doi.org/10.1097/itx.0000000000000052","url":null,"abstract":"Introduction: The visual analogue scale (VAS), the numerical rating scale (NRS), and the verbal rating scale (VRS) are routinely used to assess pruritus intensity. However, these scales have limitations, especially the ceiling effect of linear scales (VAS, NRS) and the reduced sensitivity to change of the VRS. In the labeled magnitude scale (LMS) consisting of a vertical line with verbal anchors distributed quasi-logarithmically, the ceiling effect is reduced, allowing a higher discriminative assessment at the higher end of the scale. Methods: A total of 172 patients completed the LMS twice within 30–60 minutes to assess the reliability of the scale, as well as the NRS and VAS for analyses of convergent validity. Sensitivity to change of the LMS was investigated by analyzing changes in scores after a twice-daily application of an emollient containing menthoxypropanediol for 14 days. Results: Test-retest reliability was excellent for the LMS assessing average (Cronbach α: 0.955) and worst (Cronbach α: 0.945) pruritus intensity in the last 24 hours, while strong to very strong correlations were observed between the LMS and NRS assessing the worst (r=0.783) and average (r=0.808) pruritus intensity, respectively. Treatment with an emollient lead to a significant decrease in LMS scores (P<0.01). In patients with severe pruritus at baseline (VRS ≥3), we recorded a 30.2% improvement of average pruritus intensity using the LMS compared with a 25.0% improvement using the NRS and a 27.8% improvement of worst pruritus intensity using the LMS compared with an 11.1% improvement with the NRS. Most patients considered the LMS an appropriate instrument to assess pruritus intensity (89.6%) and would use it again (91.9%). Discussion: The LMS is an appropriate well-accepted instrument to assess CP. It is especially useful to detect variations in pruritus intensity in patients with severe CP.","PeriodicalId":73523,"journal":{"name":"Itch (Philadelphia, Pa.)","volume":"6 1","pages":"e52 - e52"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42606812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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