Clinical Character istics of Itch in Patients with Adult and Childhood Atopic Dermatitis

Shim, Woo Haing; Song, Chang Hyun; Park, Hyun Je; Kim, Hoon Soo; Chin, Hyun Woo; Kim, Su Han; Ko, Hyun Chang; Kim, Moon Bum; Kim, Do Won; Kim, Byung Soo

Abstract

BACKGROUND
Itch is an essential feature of atopic dermatitis (AD). Active AD cannot be diagnosed without a history of itch. There has been no previous study delineating the different characteristics of itch according to age.
OBJECTIVE
We wanted to characterize and compare the clinical patterns and the sensory and affective dimensions of itch in adult and childhood AD patients.
METHODS
A face-to-face structured questionnaire based on the McGill pain questionnaire was given to 90 patients with AD. The patients were classified into two groups: adult AD patients (> or =15 years old) and childhood AD patients (<15 years old).
RESULTS
Eighty-eight percent of the total AD patients experienced itch everyday. This itch was mostly aggravated during the summer and at night in both groups of AD patients. The antecubital fossae, popliteal fossae and neck were the major sites of involvement with itch. More patients perceived the characteristics of itch as crawling, burning and tickling rather than stinging, stabbing and pinching. The majority of AD patients answered that sweat and hot climate aggravated the itch and medications and cold climate alleviated the itch. However, compared with the childhood patients, more adult patients experienced the aggravation of itch by exposure to dust, and the itch was alleviated by taking medications and by concentrating on work. A burning sensation with itch was more frequently reported by the adult patients when compared to that of the childhood patients.
CONCLUSION
This study highlights the detailed description and characteristics of itch in adult and childhood AD patients. The proper management of itch according to age may be prerequisite to improve AD patients' quality of life.