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Atopic dermatitis

Pruritus and relation to barrier function

Chronic pruritus (> 6 weeks of duration) is one of the most frequent skin complaints and occurs in a broad variety of diseases including dermatological, systemic, neurological, psychosomatic/psychiatric and gynaecological ones (1). According to the criteria of Hanifin et al., pruritus is an essential feature of atopic dermatitis (AD) (2). While in AD all patients suffer from pruritus, 80% of psoriasis patients have this complaint (3). Pruritus of high intensity is common in AD, (4), whereas in ichthyosis and psoriasis moderate pruritus is frequently observed(5, 6). A large questionnaire survey revealed that AD patients experience itch more frequently at night, in the evening and during the winter (4). More than half the surveyed participants reported pain (59%) and heat sensation (53%) associated with itch, which are significantly correlated with itch intensity (4). Pruritus as well as eczema in AD has a high impact on the quality of life (7,8). The Skindex comprising 16 questions has been recently developed as a specific instrument for measuring health-related quality of life (HRQoL) in dermatology patients (8). A recent study showed that improvement of AD parallels the reduction of Skindex value. In particular, the emotions score of Skindex significantly correlates with reduction of pruritus intensity (8).

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