Hand Pruritus: Clinical Profile, Functional Impairment and Disease-related Burden in a Prospective Cohort Study of 395 Patients
DOI:
https://doi.org/10.2340/00015555-3925Keywords:
chronic pruritus, itch, hands, burden, quality of life, patient-reported outcomesAbstract
Human hands are complex structures essential for a variety of functions in everyday life. This study prospectively investigated the clinical features of hand pruritus and the resulting functional impairment and disease-related burden in 395 patients with chronic pruritus (210 females, median age 59 years). Moderate to very severe hand pruritus was reported by 91.2% of patients, while 79% perceived additional sensory symptoms, such as burning, pain or tingling. A long duration of pruritus occurred in most cases (>6 months: 71.4%). A considerable proportion of patients showed moderate to severe impairment in the use of their hands (40.2%), performance of daily activities (65.0%) and quality of life (45.2%). Disease severity and burden is particularly high when both the palms and the backs of the hands are affected, and when pain is present simultaneously. Pruritus located on the hands is impairing and burdensome due to the functional relevance of the hands in everyday life.
Downloads
References
Erol K, Gok K, Cengiz G, Ozgocmen S. Hand functions in systemic sclerosis and rheumatoid arthritis and influence on clinical variables. Int J Rheum Dis 2018; 21: 249–252.
Kouris A, Armyra K, Christodoulou C, Katoulis A, Potouridou I, Tsatovidou R, et al. Quality of life, anxiety, depression and obsessive-compulsive tendencies in patients with chronic hand eczema. Contact Dermatitis 2015; 72: 367–370.
Singhal R, Diwan NG, Nair PA. Impact of palmoplantar dermatoses on quality of life. Indian Dermatol Online J 2018; 9: 309–313.
Chung J, Callis Duffin K, Takeshita J, Shin DB, Krueger GG, Robertson AD, et al. Palmoplantar psoriasis is associated with greater impairment of health-related quality of life compared with moderate to severe plaque psoriasis. J Am Acad Dermatol 2014; 71: 623–632.
Diepgen TL, Scheidt R, Weisshaar E, John SM, Hieke K. Cost of illness from occupational hand eczema in Germany. Contact Dermatitis 2013; 69: 99–106.
Politiek K, Oosterhaven JA, Vermeulen KM, Schuttelaar ML. Systematic review of cost-of-illness studies in hand eczema. Contact Dermatitis 2016; 75: 67–76.
Ruppert L, Apfelbacher C, Molin S, Bauer A, Mahler V, Schmitt J, et al. Itching in patients with chronic hand eczema: data from the CARPE registry. Dermatology 2014; 229: 146–153.
Weisshaar E, Kallen U, Weiß M. “The itching hand”– important differential diagnoses and treatment. J Dtsch Dermatol Ges 2013; 11: 31–42.
Ständer S, Weisshaar E, Mettang T, Szepietowski JC, Carstens E, Ikoma A, et al. Clinical classification of itch: a position paper of the International Forum for the Study of Itch. Acta Derm Venereol 2007; 87: 291–294.
Uter W, Schwanitz HJ, Pfahlberg A, Gefeller O. Atopic signs and symptoms: assessing the ‘atopy score’ concept. Dermatology 2001; 202: 4–8.
Phan NQ, Blome C, Fritz F, Gerss J, Reich A, Ebata T, et al. Assessment of pruritus intensity: prospective study on validity and reliability of the visual analogue scale, numerical rating scale and verbal rating scale in 471 patients with chronic pruritus. Acta Derm Venereol 2012; 92: 502–507.
Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI) – a simple practical measure for routine clinical use. Clin Exp Dermatol 1994; 19: 210–216.
Snaith RP. The Hospital Anxiety And Depression Scale. Health Qual Life Outcomes 2003; 1: 29.
Ständer S. How to define chronic pruritus: symptom or disease? Exp Dermatol 2019; 28: 1461–1465.
Cazzaniga S, Ballmer-Weber BK, Gräni N, Spring P, Bircher A, Anliker M, et al. Medical, psychological and socio-economic implications of chronic hand eczema: a cross-sectional study. J Eur Acad Dermatol Venereol 2016; 30: 628–637.
Cazzaniga S, Ballmer-Weber BK, Gräni N, Spring P, Bircher A. Chronic hand eczema: a prospective analysis of the Swiss CARPE registry focusing on factors associated with clinical and quality of life improvement. Contact Dermatitis 2018; 79: 136–148.
Truini A, Leone C, Di Stefano G, Biasiotta A, La Cesa S, Teofoli P, et al. Topographical distribution of warmth, burning and itch sensations in healthy humans. Neurosci Lett 2011; 494: 165–168.
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2021 Teresa Gabriele Nau, Viola Rau, Claudia Zeidler, Sonja Ständer, Manuel P. Pereira
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All digitalized ActaDV contents is available freely online. The Society for Publication of Acta Dermato-Venereologica owns the copyright for all material published until volume 88 (2008) and as from volume 89 (2009) the journal has been published fully Open Access, meaning the authors retain copyright to their work.
Unless otherwise specified, all Open Access articles are published under CC-BY-NC licences, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.
