Pruritus Is the Painter on the Skin: The Prevalence and Pattern of Scratch Lesions in 124 Pruritus Patients

Background: The urge to scratch is, by definition, an integral part of the perception of itch. Consequently, scratch lesions can reflectthe patient’s perception of itch, and underlying disease. However, only little is known about . scratch patterns among different itchy conditions. Methods: In this cross-sectional study, we analyzed and compared the prevalence, type, site, and distribution of scratch lesions in patients across 11 diagnostic groups of itchy conditions. Statistical analysis was performed using chi-squared test or Mann–Whitney U tests when appropriate. Results: A total of 124 patients with acute or chronic pruritus were enrolled, 82 (66.1%) of whom presented scratch lesions. Among these, erosions/excoriations were the most prevalent (56.1%), followed by erythematous striated lesions (36.6%) and crusts (35.4%). Scratch lesions were present in descending prevalence on the arms (78.2%), trunk (75.6%), legs (74.4%), and head (19.2%). Distinct scratch lesions were identified in some diagnoses, enabling us to develop a diagnostic algorithm. Conclusions: In the present study, we characterized scratch patterns in various itchy skin conditions and developed a diagnostic algorithm accordingly. However, larger studies are necessary to support our findings.