Significance of Chronic pruritus for intrapersonal burden an
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60–90 % of patients with psoriasis suffer from pruritus and 65 % report itching as one of the most burdensome symptoms, raising significant quality of life (QoL) impairments. However, pruritus is not only an intrapersonal symptom but also a psychosocial interactive phenomenon.

This study aimed to compare the disease burden and patient needs between patients with none/mild vs. moderate/severe pruritus, and to examine the impact of disease parameters and intrapersonal burden on perceived stigmatization and sexual relationships.

This cross-sectional study included German patients aged more than 18 years with psoriasis vulgaris. Disease severity was assessed with PASI (Psoriasis Area and Severity Index); patients reported on intensity of pruritus, skin-generic and pruritus-specific QoL, patient needs and benefits, anxiety and depression symptoms, dysmorphic concerns, perceived stigmatization and sexual dysfunction.

--107 patients with psoriasis participated (mean age = 46.3 ± 14.6 years; 52.3 % male): 64 with none/mild pruritus (NRS less than 3) and 43 with moderate/severe pruritus (NRS more than 4).

--Patients with moderate/severe pruritus reported more QoL impairments, depression and anxiety symptoms and dysmorphic concerns, but less treatment benefits, than those with none/mild pruritus.

--The patient needs most frequently rated as “very/quite important“ were: “be healed of all skin defects“ (88.8 %), and “be free of itching“ (87.0 %), with no differences between the groups.

--Younger age, disease severity, frequency of scratching behaviors, dysmorphic concerns and treatment benefits were positively associated with stigmatization experiences; disease severity, sleeping problems and skin-generic QoL impairments were positively associated with sexual dysfunction.

In conclusion, in patients with psoriasis, pruritus causes a major burden. Intrapersonal burden is a major influence on the social and dyadic relationships, along with the seriousness of disease. In patient-centered health care, priority should be given to treatment options effective in reducing pruritus.