Position Statement: Linear prurigo is a subtype of chronic prurigo

Area of Science:

• Dermatology
• Clinical Medicine
• Pathophysiology

Background:

• Chronic prurigo (CPG) is a distinct disease defined by chronic itching, persistent scratching, and characteristic lesions.
• Clinical presentations of CPG vary, including papules, nodules, plaques, and umbilicated lesions.
• The relationship of linear and scarring scratch lesions (LSSL) to CPG remains unclear.

Purpose of the Study:

• To establish a consensus on the classification of pruriginous LSSL.
• To define criteria for differentiating LSSL from other skin conditions.

Main Methods:

• A consensus conference involving members of the Task Force Pruritus (TFP) of the European Academy of Dermatology and Venereology.
• Discussion of representative clinical cases and application of the Delphi method for agreement.
• Consensus achieved when at least 75% of members agreed on a statement.

Main Results:

• Twenty-one voting members of the TFP participated.
• Consensus was reached that LSSL result from chronic pruritus and scratching, sharing pathophysiological links with CPG.
• LSSL are now considered within the spectrum of CPG, with 'linear prurigo' proposed as the descriptive term.

Conclusions:

• Classifying linear prurigo within the CPG spectrum has significant clinical implications for diagnosis and treatment.
• The diagnostic and therapeutic strategies for linear prurigo should align with CPG management.
• Crucially, linear prurigo must be distinguished from self-inflicted lesions in factitious disorders or skin picking syndromes, where manipulation, not itching, causes the lesions.