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Clinical characteristics of pruritus in chronic idiopathic urticaria
Author(s) -
Yosipovitch G.,
Ansari N.,
Goon A.,
Chan Y.H.,
Goh C.L.
Publication year - 2002
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1046/j.1365-2133.2002.04758.x
Subject(s) - medicine , sensation , evening , depression (economics) , itching , mcgill pain questionnaire , dermatology , burning sensation , physical therapy , visual analogue scale , physics , astronomy , neuroscience , biology , economics , macroeconomics
Summary Background Although pruritus is a predominant symptom of chronic idiopathic urticaria (CIU) its clinical characteristics have not been explored. Objectives To characterize the clinical pattern and sensory and affective dimensions of the itch experience, utilizing a comprehensive itch questionnaire. Methods A structured questionnaire based on the McGill pain questionnaire was used in 100 patients suffering from CIU randomly recruited from a tertiary referral centre. Results All 100 patients recruited with CIU completed the questionnaire. In 68 patients pruritus appeared on a daily basis. Most patients experienced their pruritus at night and in the evening ( n = 83), and 62 reported difficulty in falling asleep. Pruritus involved all body areas, but mostly the arms ( n = 86), back ( n = 78) and legs ( n = 75). Accompanying symptoms were a sensation of heat in 45 patients and sweating in 15. Most patients ( n = 98) were prescribed antihistamines (mainly sedating), of whom 34 experienced long‐term relief. The sensation of itch was reported to be stinging ( n = 27), tickling ( n = 25) and burning ( n = 23). Seventy‐six patients found their pruritus bothersome, 66 annoying and 14 complained of depression. The itch intensity at its peak was more than double that felt after a mosquito bite. The worst itch scores of those who felt depressed were significantly higher than of those who did not ( P = 0·018). There was a positive correlation between the sensory and affective scores during worst itch ( P < 0·001). Conclusions This study describes the itch experienced in CIU, highlighting sensory and affective dimensions. The itch questionnaire was found to be a valuable tool for evaluating pruritus in CIU and its unique features.