Pruritus in chronic plaque psoriasis: a questionnaire-based study of 230 Italian patients

In the past, several textbooks defined psoriasis as a non-pruritic dermatosis, but the most recent data in the literature emphasizes the high frequency of pruritus in psoriasis and its impact on the quality of life of patients with psoriasis. Aim of this study was to explore the sensory and affective dimensions of pruritus as well as to assess the impact of itch on quality of life and to evaluate the influence of lifestyles, habits, and various anti-pruritic therapies on pruritus in a large group of psoriatic subjects. The structured Yosipovitch itch questionnaire was given to 240 psoriatic patients. 230 patients returned a complete and detailed questionnaire. Pruritus was referred to by 80% of the patients. Psoriasis area and severity index (PASI) was significantly higher in itching-patients (P=0.04). In half of the patients, itching appeared daily, particularly in the evening. Significant aggravating factors of pruritus were stress, skin dryness, hot water, sweating, elevated ambient temperature, exercise, abundant meals, bad moods, lying position, and contact with clothes. Cold water is the only factor that showed to significantly relieve the pruritus. Anti-pruritic therapies had limited effect. Pruritus is a common, bothersome, and poorly responsive symptom in patients with psoriasis.