Patient Needs and Treatment Goals in Chronic Atopic Pruritus: Does Eczema Make a Difference?

Abstract

Chronic pruritus (≥ 6 weeks) is a frequent symptom in atopic diseases, with phenotypes ranging from non-lesional skin to inflammatory diseases like atopic dermatitis. Data on patients’ needs and treatment goals depending on the skin phenotype and disease burden are limited. This study aimed to analyse the impact of distinct phenotypes of chronic atopic pruritus on disease burden and treatment goals. Another objective was to investigate whether the disease burden influences the treatment goals. Patient-reported outcomes of 1,086 adult patients (n = 529 with atopic dermatitis, n = 557 with chronic pruritus on non-lesional skin with atopic skin diathesis) were analysed age- and gender-matched (mean age 49.7 ± 19.0 years; n = 605 female [55.7%]), comparing pruritus intensity (Numeric Rating Scale), quality of life (Dermatology Life Quality Index, ItchyQol), anxiety and depression (Hospital Anxiety and Depression Scale), and patient needs (Patient Needs Questionnaire of the Patient Benefit Index-Pruritus). Although the disease burden was significantly higher in patients with atopic dermatitis (prolonged disease duration, increased quality of life impairment, higher pruritus intensity), the treat-ment goals of both phenotypes matched in 92.6%. The most important needs were to no longer experience itching, find a clear diagnosis and therapy, and have confidence in the therapy.

Keywords

• atopic dermatitis
• atopic comorbidity
• chronic pruritus
• patient reported outcomes
• patient-centred care