Korean J Dermatol.  2024 Sep;62(8):437-446.

Scalp Pruritus: Classification and Clinical Characteristics

• Pyo GJ
• Choi SH
• Myung KB
• Cheong SH

Abstract

Background
Chronic scalp pruritus is a common symptom in dermatology patients. However, few studies have investigated its causes and clinical characteristics.
Objective
We aimed to evaluate in this study the causes of chronic scalp pruritus, classify itching, and the clinical manifestations associated with different causes and classifications.
Methods
A cross-sectional study was conducted involving 179 patients with chronic scalp pruritus recruited from the Department of Dermatology at Konyang University Hospital between August 2023 to February 2024. Age, sex, clinical features, Itch Numeric Rating Scale (NRS), Dermatology Life Quality Index (DLQI), and treatment response were evaluated using a questionnaire.
Results
The most common cause of chronic scalp pruritus was a dermatologic condition (n=135, 75.4%). Systemic scalp pruritus (n=15, 8.4%) was the second most common cause, followed by neuropathic pruritus (n=14, 7.8%), psychogenic scalp pruritus (n=9, 5.0%), and scalp pruritus of unknown origin (n=6, 3.4%). Patients with systemic pruritus had higher itch NRS scores compared to those with neuropathic pruritus (p=0.033). In addition, patients with dermatological pruritus experienced longer itch duration and treatment courses than patients with neuropathic pruritus (p=0.001 and p=0.005, respectively). Moreover, patients with higher itch NRS scores had higher DLQI scores among patients with dermatological pruritus (p＜0.001).
Conclusion
In this study, we classified the causes of scalp pruritus and identified the itch severity and clinical manifestations. The severity of itching, pruritus duration, treatment duration, and aggravating factors differed for each scalp pruritus classification. Understanding the classification and clinical characteristics of scalp pruritus can facilitate the development of more effective treatments.

Keyword

Classification; Pruritus; Scalp