Clinical Characteristics of Pruritus in Patients with Scalp Psoriasis and Their Relation with Intraepidermal Nerve Fiber Density
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Background: The scalp is frequently affected in psoriasispatients, and pruritus can adversely affect the quality of lifeof affected patients. Few studies have assessed pruritus inscalp psoriasis. Objective: To determine the correlationamong the clinical characteristics of pruritus, psoriasis scalpseverity index (PSSI), and intraepidermal nerve fiber (IENF)density in psoriatic scalp lesions. Methods: Eighty patients(53 men, 27 women; mean age, 46.4 years; mean PSSI, 19.9)with scalp psoriasis were evaluated by using the PSSI and theLeuven itch scale. Biopsies were obtained from the lesionaland nonlesional skin of 19 patients (10 men, 9 women; meanage, 37.8 years; mean PSSI, 25.8). Immunofluorescencestaining of protein gene product 9.5 was performed todetermine the IENF density. Results: Sixty-four patients(80%) complained of pruritus associated with scalppsoriasis, which negatively affected their quality of lif e tovarying degrees. A moderate positive relation between PSSIscore and pruritus intensity was identified (r=0.225 andp=0.044). The IENF density in psoriatic lesions wassignificantly higher than that in the nonlesional scalp(6.2±1.2 vs. 4.2±1.6, p＜0.001). However, the correlationsbetween IENF density and PSSI score, and IENF density andpruritus intensity were insignificant. Conclusion: Theseresults indicate that pruritus prevalence is high in patientswith scalp psoriasis, and pruritus considerably influences thepatients’ daily lives and quality of life. In addition, high IENFdensity in psoriatic scalp lesions may play a role in thedevelopment of pruritus in scalp psoriasis.
Abstract
Background: The scalp is frequently affected in psoriasispatients, and pruritus can adversely affect the quality of lifeof affected patients. Few studies have assessed pruritus inscalp psoriasis. Objective: To determine the correlationamong the clinical characteristics of pruritus, psoriasis scalpseverity index (PSSI), and intraepidermal nerve fiber (IENF)density in psoriatic scalp lesions. Methods: Eighty patients(53 men, 27 women; mean age, 46.4 years; mean PSSI, 19.9)with scalp psoriasis were evaluated by using the PSSI and theLeuven itch scale. Biopsies were obtained from the lesionaland nonlesional skin of 19 patients (10 men, 9 women; meanage, 37.8 years; mean PSSI, 25.8). Immunofluorescencestaining of protein gene product 9.5 was performed todetermine the IENF density. Results: Sixty-four patients(80%) complained of pruritus associated with scalppsoriasis, which negatively affected their quality of life tovarying degrees. A moderate positive relation between PSSIscore and pruritus intensity was identified (r=0.225 andp=0.044). The IENF density in psoriatic lesions wassignificantly higher than that in the nonlesional scalp(6.2±1.2 vs. 4.2±1.6, p＜0.001). However, the correlationsbetween IENF density and PSSI score, and IENF density andpruritus intensity were insignificant. Conclusion: Theseresults indicate that pruritus prevalence is high in patientswith scalp psoriasis, and pruritus considerably influences thepatients’ daily lives and quality of life. In addition, high IENFdensity in psoriatic scalp lesions may play a role in thedevelopment of pruritus in scalp psoriasis.
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