Ann Dermatol.  2014 Dec;26(6):727-732. 10.5021/ad.2014.26.6.727.

Clinical Characteristics of Pruritus in Patients with Scalp Psoriasis and Their Relation with Intraepidermal Nerve Fiber Density

• Kim TW
• Shim WH
• Kim JM
• Mun JH
• Song M
• Kim HS
• Ko HC
• Kim MB
• Kim BS

• KMID: 2264868
• DOI: http://doi.org/10.5021/ad.2014.26.6.727

Abstract

BACKGROUND
The scalp is frequently affected in psoriasis patients, and pruritus can adversely affect the quality of life of affected patients. Few studies have assessed pruritus in scalp psoriasis.
OBJECTIVE
To determine the correlation among the clinical characteristics of pruritus, psoriasis scalp severity 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 the Leuven itch scale. Biopsies were obtained from the lesional and nonlesional skin of 19 patients (10 men, 9 women; mean age, 37.8 years; mean PSSI, 25.8). Immunofluorescence staining of protein gene product 9.5 was performed to determine the IENF density.
RESULTS
Sixty-four patients (80%) complained of pruritus associated with scalp psoriasis, which negatively affected their quality of life to varying degrees. A moderate positive relation between PSSI score and pruritus intensity was identified (r=0.225 and p=0.044). The IENF density in psoriatic lesions was significantly higher than that in the nonlesional scalp (6.2+/-1.2 vs. 4.2+/-1.6, p<0.001). However, the correlations between IENF density and PSSI score, and IENF density and pruritus intensity were insignificant.
CONCLUSION
These results indicate that pruritus prevalence is high in patients with scalp psoriasis, and pruritus considerably influences the patients' daily lives and quality of life. In addition, high IENF density in psoriatic scalp lesions may play a role in the development of pruritus in scalp psoriasis.

Keyword

Nerve fibers; Pruritus; Psoriasis; Scale; Scalp dermatoses

MeSH Terms

Biopsy
Female
Fluorescent Antibody Technique
Humans
Male
Nerve Fibers*
Prevalence
Pruritus*
Psoriasis*
Quality of Life
Scalp Dermatoses
Scalp*
Skin

Figure

• 

  Fig. 1 Correlation between psoriasis scalp severity index (PSSI) score and intensity of pruritus (visual analogue scale [VAS]) (r=0.225, p=0.044).

• 

  Fig. 2 Immunofluorescence micrographs of psoriatic (A) and nonlesional (B) scalp after incubation with antiserum to protein gene product 9.5 (PGP 9.5). Scale bar=50 µm. (C) Semiquantitative analysis of the number of PGP 9.5-immunoreactive nerve fibers clearly penetrating the basement membrane.

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