ABSTRACT
BACKGROUND: Currently available tools to monitor patients with chronic prurigo over time focus on pruritus and quality of life parameters, while no instrument objectively assessing the pruriginous lesions is yet available. OBJECTIVE: The objective of this study was to develop a physician-assessed Prurigo Activity Score (PAS), a new tool to monitor the distribution and activity of chronic prurigo lesions and to evaluate its reliability and validity. METHODS: The 7-item PAS questionnaire as well as validated pruritus intensity scales (VAS, NRS) and a skin-related quality of life score (DLQI) were completed for 264 patients (172 females, age 61 years) at least twice over a period of 2 years. In addition, a 60-min test-retest reliability test was performed by four experts for a random sample of 12 patients. RESULTS: The PAS showed good test-retest reliability (Cohens κ > 0.61; Cronbach-alpha > 0.76), ordinal or metric items showed high inter-rater reliability (Kendalls > 0.61) and items recording the number of lesions correlated significantly to each other (P < 0.001). The highest correlation to external constructs was achieved with DLQI. The feasibility test conducted by four raters indicated the suitability of PAS for tracking chronic prurigo in the clinical setting. DISCUSSION: The PAS is a useful tool to objectively monitor pruriginous lesions in chronic prurigo patients over time. The sensitivity of change in the PAS score should be analysed in future studies.
Subject(s)
Prurigo/complications , Severity of Illness Index , Aged , Chronic Disease , Feasibility Studies , Female , Humans , Male , Middle Aged , Observer Variation , Pruritus/etiology , Quality of Life , Reproducibility of ResultsSubject(s)
Stevens-Johnson Syndrome/etiology , Thiocarbamates/toxicity , Female , Humans , Middle AgedABSTRACT
The term prurigo is still used to designate primary dermatoses and secondary reaction patterns. A clear definition of the term is not available nor a clear clinical classification of diseases categorized under the term. Furthermore, there is no certainty about the entity it was primarily used to refer to, and whether it should always be considered in relation to pruritus. The concept appears already in very early medical treatises. From the very beginning, it was used in dermatology in a non-uniform way, and was alternately accorded and denied the status of an independent disease entity. Moreover, prurigo was subdivided into many different forms, but their descriptions are partly very similar, so that, for instance, it is quite difficult today to draw any conclusions about the clinical entities the frequently used terms prurigo mitis and prurigo formicans referred to. In contrast, the term prurigo nodularis is still commonly used. This article traces exemplarily the use of the term prurigo in the standard medical textbooks up to the definition of prurigo nodularis.
Subject(s)
Dermatology/history , Prurigo/classification , Prurigo/history , Terminology as Topic , History, 19th Century , History, 20th Century , History, 21st Century , HumansABSTRACT
BACKGROUND: There is no consistent definition of the term prurigo and a clear classification is unavailable. OBJECTIVES: Definition of the current forms of prurigo and a new approach to a specific classification. METHODS: Review of the types of prurigo as presented in current textbooks and publications. RESULTS: Pruritus is the main symptom of prurigo and shows an intensely pruritic papule or nodule as the main efflorescence. The term prurigo is not only used for secondary lesions, but also for primary dermatoses. The different forms of prurigo obtain their names depending on etiology, onset and duration of lesions or the clinical appearance. CONCLUSIONS: The term prurigo has not been used consistently. A revision of the classification with a clear distinction between primary dermatoses and secondary lesions seems reasonable. In secondary prurigo, a clinical classification and the cause should be mentioned.
Subject(s)
Prurigo/classification , Prurigo/diagnosis , Pruritus/classification , Pruritus/diagnosis , Terminology as Topic , Diagnosis, Differential , Humans , Prurigo/complications , Pruritus/etiologyABSTRACT
The efficacy of an organo-heparinoid ointment (Hirudoid 40,000) compared with a placebo ointment was tested in a double blind trial on 40 patients with post-operative infusion thrombophlebitis. It was possible to provide objective data by means of the 125I-fibrinogen test for accelerated regression of thrombi following treatment with organo-heparinoid. The differences found between the 2 treatment groups were statistically significant. The clinical results conformed largely to the measured data. Especially pain and swelling were favourably affected by treatment with the active compound. 1 case of local allergic reaction to organo-heparinoid was observed. No further side-effects were seen.