11 / 28
Nocturnal pruritus common among pruritic
conditions, diminishes quality of life
N
octurnal pruritus was found to be a
common complaint among a wide
range of pruritic conditions, and
exerts a negative impact on quality of life,
report results of a retrospective analysis.
Michael Lavery, MD, of Lewis Katz School
of Medicine at Temple University, Philadel-
phia, and colleagues set out to assess the
prevalence, characteristics, and impact
on quality of life of patients with noctur-
nal pruritus.
Patients who attended an “itch clinic” from
2015 to 2016 were surveyed. Patients with
chronic itch (≥6 weeks) were asked to
complete a validated questionnaire assess-
ment of pruritus.
This itch questionnaire assessed the
severity of itch on a numeric rating scale
of 0–10 and several associated character-
istics, including the presence and severity
of nocturnal pruritus and sleep disturbance
on a scale of 0–4. A validated quality of life
questionnaire (ItchyQ) was also completed.
Questionnaires from 160 subjects were
analysed. Mean subject age was 57 ± 16.
Ninety-seven (60.6%) of the cohort were
female and 63 (39.4%) were male. A total
of 146 of the 160 subjects (91.3%) reported
suffering from nocturnal pruritus.
The most common conditions that
co-occurred with nocturnal pruritus were
atopic dermatitis, prurigo nodularis,
brachioradial pruritus, and psoriasis.
Mean itch intensity severity was signifi-
cantly high (8.2 ± 2.1). Subjects reported
significantly higher itch severity at night vs
during the day (P < 0.0001). The severity
of nocturnal pruritus was significantly cor-
related with overall itch severity (r = 0.22, P
= 0.006). Of the 146 subjects with nocturnal
pruritus, 90% reported sleep disturbance.
Furthermore, for subjects with nocturnal
pruritus, the severity of itch at night corre-
lated significantly with the severity of sleep
disturbance (r = 0.35, P < 0.0001).
The severity of nocturnal pruritus corre-
lated significantly with total Itchy Quality
of Life score (r = 0.22, P = 0.006), indicating
that nocturnal pruritus was associated with
an overall reduced quality of life.
Specifically, the severity of nocturnal pruri-
tus correlated with two of the Itchy Quality
of Life subscales: functioning (r = 0.29, P =
0.0004) and emotions (r = 0.18, P = 0.03).
Dr Lavery concluded that nocturnal pruri-
tus was found to be a common complaint
among a wide range of pruritic conditions,
and exerts a negative impact on quality of
life. The results highlight the need for tar-
geted clinical interventions for patients with
chronic pruritus.
PracticeUpdate Editorial Team
The results highlight the need
for targeted clinical
interventions for patients
with chronic pruritus.
PATIENTS WHO TEST POSITIVE
FOR THE BRAF MUTATION MAY
BE ELIGIBLE FOR TARGETED
MELANOMA THERAPIES
1,2
BRAF mutation tests are recommended for the following patients:
2
MANDATORY
• Unresectable stage III or IV
HIGHLY RECOMMENDED
• High-risk resected stage IIc or stage IIIb–IIIc
~40%
OF PATIENTS
WITH MELANOMA
HARBOUR THE
BRAF MUTATION
3
REQUEST THE
BRAF TEST
FOR YOUR PATIENTS WITH MELANOMA.
CONFIRM BRAF MUTATION STATUS EARLY
HELP EXPEDITE ACCESS TO TARGETED
THERAPIES FOR ADVANCED MELANOMA
10/4/17 3:34 pm
2017 AAD ANNUAL MEETING
11
VOL. 1 • NO. • 2017