Chronic Itch Affects Patients' Ability to Experience Pleasure: Anhedonia in Itchy Disorders.

Anhedonia, the reduced ability to experience pleasure, is a prevalent symptom in various psychiatric disorders, but has not been investigated in dermatological conditions, particularly those characterized by chronic itch. This study aimed to examine the prevalence and clinical correlates of anhedonia in patients with chronic itch. A cross-sectional study was conducted in 137 patients with chronic itch, classified according to the International Forum for the Study of Itch (IFSI) classification. Anhedonia was assessed using the Snaith-Hamilton Pleasure Scale (SHAPS) and Anticipatory and Consummatory Interpersonal Pleasure Scale (ACIPS). Itch severity, quality of life, and psychological distress were assessed using the Visual Analogue Scale (VAS), Verbal Rating Scale (VRS), ItchyQoL, and Hospital Anxiety and Depression Scale (HADS), respectively. The mean SHAPS score was 1.0 ± 1.7 points, and the mean ACIPS total score was 76.9 ± 16.2 points. In the study sample, 13.1% of patients were identified as anhedonic, with a higher prevalence observed in those with severe and very severe itch. Anhedonia was significantly correlated with itch severity (R = 0.2, p=0.02 for 24 h VASmean and SHAPS; R = 0.2, p = 0.01 for 24 h VASmax and SHAPS), anxiety symptoms (R = 0.3, p < 0.001 for SHAPS and HADS-anxiety), depression symptoms (R = 0.4, p < 0.001 for SHAPS and HADS-depression), and impairment in quality of life (R = 0.2, p = 0.014 for SHAPS and ItchyQoL). Anhedonia is a significant and prevalent aspect of psychological distress in patients with chronic itch. Addressing this symptom may not only improve patients' overall mental health but also enhance the effectiveness of treatments for chronic itch. Future research is needed to elucidate further the mechanisms underlying the relationship between anhedonia and chronic itch and to develop targeted interventions for this population.

Characteristics of pruritus in various clinical variants of psoriasis: Final report of the binational, multicentre, cross-sectional study.

BACKGROUND: Pruritus, which is the most frequent subjective symptom of psoriasis, may cause significant discomfort, embarrassment and even interfere with patients normal daily activities. However, the perception of itch in various psoriasis subtypes remains unknown. OBJECTIVES: The aim of this study was to investigate and to characterize pruritus in different clinical variants of psoriasis. METHODS: This cross-sectional, binational, multicentre study included 295 subjects suffering from nine different clinical subtypes of psoriasis: large-plaque psoriasis (n = 45), nummular psoriasis (n = 32), guttate psoriasis (n = 31), scalp psoriasis (n = 32), inverse psoriasis (n = 23), erythrodermic psoriasis (n = 33), palmoplantar psoriasis vulgaris (n = 33), palmoplantar pustular psoriasis (n = 42) and generalized pustular psoriasis (n = 23). Measures included sociodemographic and anthropometric data, detailed pruritus characteristics including but not limited to pruritus intensity, frequency and extend, as well as psoriasis severity. RESULTS: The lifetime prevalence of pruritus in each clinical variant of psoriasis was similar and quite high, reaching up to 100% in some disease subtypes (i.e., nummular psoriasis, scalp psoriasis and generalized pustular psoriasis). Psoriasis severity correlated with pruritus intensity in scalp psoriasis, palmoplantar pustular psoriasis and generalized pustular psoriasis. The age, duration of psoriasis and BMI did not interfere with the intensity of itch. CONCLUSIONS: Pruritus is highly prevalent in each clinical variant of psoriasis. However, the sensation of itch is very individual, difficult to universally describe even in the same subtype.

Basal cell carcinoma and rosacea: coincidence or relationship?

Introduction: The relationship between rosacea and basal cell carcinoma (BCC) is still not known. Almost all reports questioning the relation between BCC and rosacea are focused on rhinophyma. Aim: To examine the possible connection of BCC and rosacea. Material and methods: 110 patients with BCC located on the face treated surgically in the Dermatosurgery Unit in 2020-2021 were included in the study. A trained dermatologist assessed the presence or absence of concomitant rosacea and assessed its severity according to the Investigator's Global Assessment (IGA). Results: Fifty-one (46.4%) subjects with BCC and concomitant clinically diagnosed rosacea were found. In our group 35.5% of women had BCC located on the cheeks, while in men most cancers were located on the nose (55%, n = 11), however this difference has not reached statistical significance. Conclusions: The incidence of rosacea in our population was undoubtedly higher, comparing to the normative population. Both rosacea and BCC share the same risk factors - UV exposure, the potential association should not be neglected.

Translation and validation of the Polish language version of the Teenagers Quality of Life questionnaire (T-QoL).

Introduction: Skin diseases affect patients at any age, but as each period in life is different, tools used to assess quality of life impairment should be adjusted according to the particular age group. Adolescence is a unique time, when young individuals go through many changes, making them especially vulnerable to stress. Aim: Translation and validation of a Polish language version of the Teenagers Quality of Life questionnaire (T-QoL) questionnaire. Material and methods: T-QoL was translated following international guidelines. A group of 34 dermatological patients, aged 12-19 years old, with various skin diseases were given the T-QoL as well as the CDLQI or DLQI to complete. They were also asked to complete the T-QoL questionnaire for the second time after 3-5 days. Statistical analysis of the results was performed. Results: The Polish version of T-QoL is internally consistent (Cronbach α 0.893 for the whole questionnaire). Moreover, it presents very good convergent validity (ICC = 0.864). No statistically significant differences between each question were noticed between the first and second time of completing the form. T-QoL scores correlated significantly with DLQI (p = 0.008, r = 0.636) and CDLQI (p < 0.001, r = 0.777) scores. Conclusions: The Polish version of the T-QoL questionnaire is a reliable instrument with adequate convergent validity, consistency and reproducibility. It can be successfully used to measure quality of life impairment among teenagers.

Burden of Itch in Patients with Basal Cell Carcinoma.

The incidence of basal cell carcinoma has increased in recent years. The aim of this study was to analyse the influence of itch on quality of life and psychosocial status of patients with basal cell carcinoma. A total of 180 patients with basal cell carcinoma were included in the study. Itch intensity was assessed with Numerical Rating Scale and 4-Item Itch Questionnaire (4IIQ). Quality of life in basal cell carcinoma was assessed with the 36-item Short-Form Health Survey (SF-36), Dermatology Life Quality Index (DLQI), 6 Item Stigmatization Scale (6-ISS) and Beck Depression Inventory (BDI). Mean DLQI in the study group was 2.0 ± 2.0, while mean SF-36 was 71.38 ± 15.77 points. The intensity of itch assessed with 4IIQ correlated negatively with SF-36 (R = -0.48, p = 0.003). The mean ± SD BDI score was 6.16 ± 5.72 points and mean 6-ISS score was 0.66 ± 1.24. In conclusion, presence and intensity of itch may debilitate quality of life among patients with basal cell carcinoma.

Itch in diabetes: a common underestimated problem.

Introduction: Diabetes mellitus is associated with several skin manifestations, however the association with itch remains unclear. Aim: To present a detailed literature review in order to analyse the frequency, pathogenesis, and course of itch in diabetes mellitus. Material and methods: Data were collected from the PubMed and Cochrane databases. Articles were excluded if the populations presented with comorbidities or received treatment with drugs affecting the skin. Also, animal studies, studies with poor methodology and pilot studies were excluded. Results: Among the 5 original articles included, the epidemiology of itch in diabetes varies from 18.4% to 27.5%. Two main factors are associated with the pathogenesis of itch in diabetes, namely skin xerosis and diabetic polyneuropathy. It is still poorly defined how glycaemic control is associated with generalized itch. No treatment of choice is available; however, topical therapy (emollients) provides significant relief in varying percentages of patients. Conclusions: The results indicate a benefit of diabetes screening in individuals presenting with chronic itch without primary skin lesions.

Basal cell carcinoma: what new can be learned about the most common human cancer? A cross-sectional prospective study of 180 cases in a single centre.

INTRODUCTION: Basal cell carcinoma (BCC) is the most common cancer in humans, but the reporting of patients with BCC is still not complete. There are a limited number of analyses in the literature on BCC epidemiology. AIM: To study the epidemiological as well as clinical aspects of BCC by analysing a single centre's experience in the Lower Silesia region of Poland. MATERIAL AND METHODS: We investigated 180 patients with BCC treated in the Unit of Dermatosurgery, Department of Dermatology, Venereology, and Allergology of Wroclaw Medical University between September 2017 and December 2019. RESULTS: The mean age of patients with BCC was 70.5 ±11.9 years. The most frequently diagnosed type of BCC was nodular type, at 72% of all patients. BCC occurred most commonly on the face and neck area, at 132 (73.3%), without a statistical difference between males and females. The vast majority of cancers were located on the nose. There was a personal history of skin cancer in 29% of our patients. In 127 (70.6%) subjects, the diameter of the BCC on the day of excision was less than 2 cm. CONCLUSIONS: The clinical characteristics of our cohort of BCC patients has some similarities with that reported from central Poland and other European countries. However, we found an increase in the incidence of BCC among females.

Basal cell carcinoma within rhinophyma: coincidence or relationship?

INTRODUCTION: Rhinophyma is a relatively rare form of rosacea, while basal cell carcinoma (BCC) is the most frequent skin cancer in humans - both diseases prevail in the elderly. AIM: To analyse patients with rhinophyma treated surgically in the Dermatosurgery Unit and look for possible cases with BCC within the rhinophyma. MATERIAL AND METHODS: We performed a retrospective review of all treated rhinophymas in the Dermatosurgery Unit in 2004-2019. RESULTS: Among 140 rhinophyma patients 2 (1.4%) subjects with concomitant clinically diagnosed and histologically confirmed BCC were found, with BCC located in the hypertrophic tissue of the nose. There were no patients with BCC located in other anatomical regions of the skin. Both of these patients were in more advanced age. CONCLUSIONS: Taking into consideration these two conditions: advanced age and anatomical location, typical for BCC, one may speculate that the development of BCC within rhinophyma is rather a simple coincidence. However, more numerous series of patients with rhinophyma are needed to clear the controversy of BCC within rhinophyma hypertrophic tissue.

Basal cell carcinoma-Primary closure of moderate defect of mid forehead.

This is a case presentation of successful defect repair after radical surgical excision of a moderately large basal cell carcinoma by a simple procedure taking advantage of a patient's individual face features.

Itch in the era of COVID-19 pandemic: An unfolding scenario.

Coronavirus disease 2019 (COVID-19) is an infectious disease, caused by severe acute respiratory syndrome (SARS)-CoV-2, that broke out in December 2019. In just 4 months it has spread to almost every country in the world and up to April 18, 2020, the virus has infected more than two million people. Itch is the most common symptom in dermatology and a frequent one of systemic diseases. The association of itch and viral diseases has been widely documented; however, the actual prevalence of itch in the patients suffering from new the SARS-CoV-2 infection is still unknown. In this paper, we present a review of the available literature on the topic of itch in the affected population. Moreover, we have also analyzed different aspects of itch associated with COVID-19 pandemic, not directly related to the viral infection. Those included use of chemicals, hand sanitizers, common use of personal protective equipment and psychosocial stress.

Could Residents Adequately Assess the Severity of Hidradenitis Suppurativa? Interrater and Intrarater Reliability Assessment of Major Scoring Systems.

A wide variety of assessment tools have been proposed for hidradenitis suppurativa (HS) until now, but none of them meets the criteria for an ideal score. Because there is no gold standard scoring system, the choice of the measure instrument depends on the purpose of use and even on the physician's experience in the subject of HS. The aim of this study was to assess the intrarater and interrater reliability of 6 scoring systems commonly used for grading severity of HS: the Hurley Staging System, the Refined Hurley Staging, the Hidradenitis Suppurativa Severity Score System (IHS4), the Hidradenitis Suppurativa Severity Index (HSSI), the Sartorius Hidradenitis Suppurativa Score and the Hidradenitis Suppurativa Physician's Global Assessment Scale (HS-PGA). On the scoring day, 9 HS patients underwent a physical examination and disease severity assessment by a group of 16 dermatology residents using all evaluated instruments. Then, intrarater reliability was calculated using intraclass correlation coefficient (ICC), and interrater variability was evaluated using the coefficient of variation (CV). In all 6 scorings the ICCs were >0.75, indicating high intrarater reliability of all presented scales. The study has also demonstrated moderate agreement between raters in most of the evaluated measure instruments. The most reproducible methods, according to CVs, seem to be the Hurley staging, IHS4, and HSSI. None of the 6 evaluated scoring systems showed a significant advantage over the other when comparing ICCs, and all the instruments seem to be very reliable methods. The interrater reliability was usually good, but the most repeatable results between researchers were obtained for the easiest scales, including Hurley scoring, IHS4 and HSSI.