Highlights from

EADV 2019

28th EADV Congress

Madrid, Spain 9 - 13 October 2019

Reduced sleep quality in dermatoses influenced by itch and pain

Patients with hidradenitis suppurativa (HS), atopic dermatitis (AD), and plaque psoriasis often experience sleeping problems. In HS, pain and itch increases the frequency of insomnia, and the pain was associated to poor sleeping quality [1].

Dermatoses like HS, AD, and psoriasis entail varying intensities of itch and pain that can have a negative influence on the quality of life of the affected patients. Dr Karolina Kaaz (Wroclaw Medical University, Poland) and her colleagues evaluated the influence of itch and pain on the sleep of HS patients and compared this with AD and psoriasis patients. Data on 108 patients with HS, 100 with AD, and 100 with psoriasis were included. The HS patients had a mean age 36.3, 47% was female, and their mean Hidradenitis Severity Score was 34.8. In the AD group, 42% was female, mean age 39.2, and patients had a mean Scoring of Atopic Dermatitis (SCORAD) of 33.6, while the psoriasis patients were aged 44.1 years, 39% was female, and they had a mean Psoriasis Area and Severity Index score (PASI) of 13.5.

Itch and pain were assessed using a visual analogue scale (VAS). Insomnia and sleep quality were evaluated by the Athens Insomnia Scale (AIS) and the Pittsburgh Sleep Quality Index. The 3 groups showed mean values in Dermatology Life Quality Index (DLQI) of 13.0 (HS), 16.4 (AD), and 12.8 (psoriasis). Severe itch was only present in 14% of HS, but 60% of AD and 46% of psoriasis patients. Looking at pain rates in the HS group, the investigators found 21% severe, 17% moderate, and 42% mild pain. 66% of the AD and 83% of the psoriasis subjects did not report any pain and only 13% of AD and 11% of psoriasis patients suffered from severe pain. In HS patients, a significant correlation between grade of itch/pain and AIS scores was found (P=0.03). Mean AIS scores for HS were lower than those in AD (P<0.0001) and psoriasis (P=0.02). With mean total scores of 6.5, 8.3, and 8.1, 70% of HS and 80% of AD/PP patients were over the cut-off value of ≥ 5, which stands for poor sleeping quality. In HS, the magnitude of itch and pain correlated to the established AIS values.

The authors concluded that the impact of itch was important for patients of all 3 chronic dermatoses. Especially for HS, they emphasised that itch and pain did not only affect insomnia incidence, but pain also influenced sleep quality.

1 Kaaz K, et al. P1846, EADV 2019, 9-13 Oct, Madrid, Spain.

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