Prevalence of pruritus in patients with dermatoses and skin neoplasms: a multicenter, cross-sectional, observational study

BACKGROUND: Limited epidemiological studies on pruritus in skin diseases, as well as the absence of comparative studies on pruritus in dermatoses and skin neoplasms, highlight the relevance of this work.

AIM: This study aimed to assess the prevalence and clinical characteristics of pruritus in patients with dermatoses and skin neoplasms.

METHODS: A cross-sectional, single-arm study was conducted in three outpatient dermatology clinics. The prevalence of pruritus was assessed using a survey (the presence of pruritus within the last day); furthermore, the duration of pruritus (more or less than 6 weeks; chronic or acute pruritus, respectively) was indicated. The severity of pruritus was assessed using a pruritus numerical rating scale (0 to 10 points).

RESULTS: The study sample included 1788 patients with dermatoses (533 men; 29.8%) aged 18–84 years (median: 43 [32; 59] years). Of these, acne (8.1%), psoriasis (7.4%), dermatitis due to substances taken internally (6.5%), and atopic dermatitis (5.7%) were the most prevalent. The most prevalent skin neoplasms were melanocytic nevi (25.8%), seborrheic keratosis (7.9%), melanoma (6.4%), and other malignant (4.2%) and benign (2%) skin neoplasms. In the pooled sample of patients with dermatoses and skin neoplasms, pruritus was reported in 29.9% of cases (acute pruritus in 58.4% of patients and chronic pruritus in 40.6% of patients; median severity according to visual analog scale: 4.0 [2.0; 6.0]). Pruritus was more common in dermatoses than in skin neoplasms (34.2% vs 7.2%; р < 0.001). There were no significant differences in the incidence of acute and chronic pruritus between patients with dermatoses and skin neoplasms. The severity of pruritus was significantly higher in dermatoses than in skin neoplasms (р < 0.001). There were no sex-related differences between patients with and without pruritus (р = 0.133). Patients with pruritus were older than those without pruritus (median age: 44.0 [32.0–61.0] years vs 42.0 [31.0–58.0] years; р = 0.024). Acute pruritus was more common than chronic pruritus (58.4% vs 41.6%), and was more prevalent in dermatoses than in skin neoplasms (34.2% vs 7.2%). There were no significant differences in the characteristics of pruritus between male and female patients.

CONCLUSION: The study confirmed a higher prevalence of pruritus in dermatoses, including skin diseases that are generally considered nonpruritic, such as acne and psoriasis. Pruritus was more prevalent in skin cancers (primarily melanoma), with the highest prevalence reported for melanocytic nevi. However, this symptom was not specific to cancers.