Skin pain is common in patients with atopic dermatitis (AD) and should be evaluated along with itch severity, according to a recent study.For their study, the researchers evaluated 305 patients ages 13 to 97 years with 564 encounters. Approximately 63.9% of patients were women, and 63.7% were white. Mean age at patient-reported AD onset was 29.6 years.
All patients in the study were administered questionnaires and were evaluated by a dermatologist.
A total of 144 (42.7%) patients reported past-week skin pain, of whom 42 (13.8%) reported severe or very severe skin pain. Twenty-four (16.8%) patients believed their skin pain was part of their itch, while 16 (11.2%) thought it was from scratching, and 77 (72.0%) thought it was from both.
In addition, findings from the study showed that patients with skin pain more often described their itch in terms resembling neuropathic pain. Skin pain was more prevalent in patients with excoriations (72.6%) than in those without excoriations (57.6%). The researchers found that the severity of skin pain was most strongly correlated with the Patient-Oriented Eczema Measure (Spearman ρ = 0.54), followed by ItchyQOL (ρ = 0.52), 5-dimensions of itch scale (ρ = 0.47), Dermatology Life Quality Index (ρ = 0.45), and several other questionnaires.
The researchers noted that patients who had both both severe itch and pain demonstrated significant increases in all these measures compared with patients in whom either 1 symptom or neither symptom was severe.
“Skin pain is a common and burdensome symptom in AD,” the researchers concluded. “Skin pain severity should be assessed with itch severity in AD patients and may be an important end point for monitoring treatment response.”
—Christina Vogt
Reference:
Vakharia PP, Chopra R, Sacotte R, et al. Burden of skin pain in atopic dermatitis. Ann Allergy Asthma Immunol. 2017;119(6):548-552.e3. https://dx.doi.org/10.1016/j.anai.2017.09.076.
