Chronic pruritus in autoimmune dermatoses : results of a comparative survey

Schröder L, Hertl M, Chatzigeorgakidis E, Phan NQ, Ständer S

Abstract

As the frequency and characteristics of chronic pruritus in autoimmune dermatoses (AID) have not yet been investigated, the present study aimed at characterizing pruritus in a representative group of patients with AID. A total of 35 patients (80% women) with AID were included, divided into 3 main groups (group 1; n = 19: bullous pemphigoid (BP), pemphigus vulgaris (PV); group 2; n = 9: scleroderma (SSc), morphea (Mo); group 3; n = 7: lupus erythematosus (LE), dermatomyositis (DM). Demographic data and pruritus characteristics were obtained by standardized questionnaires and statistically evaluated by SPSS 20.0. In group 1 (BP/PV) and group 3 (LE/DM), pruritus preceded the initial diagnosis of AID (2.1 ± 7.6 years and 9.5 ± 16.0 years). Patients in group 2 (SSc/Mo) reported pruritus initially 2.8 ± 8.6 years after the initial diagnosis. In group 1 (BP/PV) significantly (p < 0.05) more excoriations and relief by scratching were observed than in groups 2 (SSc/Mo) and 3 (LE/DM). While pruritus occurred as a prodromal symptom of BP/PV and LE/DM, it was only detected once the initial diagnosis of SSc/Mo was made. In contrast to BP/PV, the other forms of AID were associated with mechanically inducible pruritus with dysesthetic qualities. All forms of AID were associated with intensive pruritus which had a significant impact on quality of life.