Pruritus as a leading symptom: clinical characteristics and quality of life in German and Ugandan patients
Abstract
BACKGROUND: Pruritus is the most frequent and distressing symptom associated with dermatoses and various internal and neurological diseases. OBJECTIVES: To investigate two different populations of patients with pruritus, one in Germany and one in Uganda, with a particular focus on clinical characteristics, aetiology and quality of life. METHODS: We investigated by questionnaire 132 patients (59 men, 73 women, mean age 54.5 years) who were referred to the Department of Dermatology at the University Hospital of Magdeburg, Germany, with the diagnosis of pruritus as a leading symptom. The questionnaire was also applied in 84 patients who consulted the Dermatology Clinic at Mbarara, Uganda for pruritus. The questions referred to personal data and disease history of the individual, history and present occurrence of concomitant diseases, present and past therapy, quality, frequency and triggers of itching and scratching, other disorders and complaints, quality of life and impact on work and disability. RESULTS: Seventy-five (57%) of the German patients had pruritus due to dermatoses, 47 patients (36%) had pruritus due to a systemic disease and in 10 patients (8%) pruritus was of unknown origin. Most had a history of pruritus of several months up to years. Pruritus associated with dermatoses mostly affected the whole body and was permanent with an undulatory character. Affective reactions such as aggression and depression occurred more frequently in dermatological patients compared with those with systemic pruritus. The former group felt that pruritus had a greater impact on their lives. Almost all Ugandan patients had pruritus due to dermatoses except for three patients with pruritus of unknown origin. Eczema and prurigo were the most frequently observed dermatoses in both German and Ugandan patients. Patients with pruritus in both populations showed an impaired quality of life. There was no pronounced difference between the populations with regard to feelings of depression and suicidal thoughts. CONCLUSIONS: A great deal of helpful information in this complex group of patients can be obtained using this questionnaire. Pruritus has a major impact on quality of life and especially impairs those patients with pruritus associated with dermatoses and pruritus of unknown origin.
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German patients were older, more likely to have end-stage renal disease, and more impacted by itch.
“German patients were older, more likely to have end-stage renal disease, and more impacted by itch.”
From Global Burden of Skin Disease: Inequities and Innovations (2017) · cites this paper as [13]
In Ugandan patients, there is a significant burden of depressed mood and poor self-image secondary to pruritus.
“a study of QoL in Ugandan patients found a significant burden of depressed mood and poor self-image secondary to pruritus”
From Global Burden of Skin Disease: Inequities and Innovations (2017) · cites this paper as [13]
Pruritus had an adverse effect on quality of life in both primary dermatoses and systemic disorders, though primary dermatoses were more commonly associated with poor self-image.
“Pruritus had an adverse effect on QoL in both primary dermatoses and systemic disorders, though primary dermatoses were more commonly associated with poor self-image.”
From Global Burden of Skin Disease: Inequities and Innovations (2017) · cites this paper as [13]
Conditions with the highest disability burden often have disabling symptoms such as pruritus, including dermatitis, prurigo, and papular urticaria.
“Conditions that constitute the highest disability burden are often characterized by disabling symptoms like pruritus. These conditions include dermatitis, prurigo, and papular urticaria”
From Global Burden of Skin Disease: Inequities and Innovations (2017) · cites this paper as [13]
Approximately 8% of Ugandan participants reported suicidal ideation.
“Approximately 8% of participants reported suicidal ideation.”
From Global Burden of Skin Disease: Inequities and Innovations (2017) · cites this paper as [13]
Fewer studies directly compare quality of life in resource-poor versus resource-replete settings.
“Fewer still directly compare QoL in resource-poor to resource-replete settings”
From Global Burden of Skin Disease: Inequities and Innovations (2017) · cites this paper as [13]
Far fewer studies examine quality of life in patients with skin conditions in resource-poor settings than in resource-replete settings.
“Far fewer studies exist examining the QoL of patients with skin conditions in the resource-poor world”
From Global Burden of Skin Disease: Inequities and Innovations (2017) · cites this paper as [13]
Ugandan patients with itch were younger, more likely to have HIV, and less impacted by itch compared to German patients.
“Ugandan patients with itch were younger, more likely to have HIV, and less impacted by itch when compared to German patients.”
From Global Burden of Skin Disease: Inequities and Innovations (2017) · cites this paper as [13]
Limited data highlights regional and cultural variations in the impact of dermatological symptoms, such as quality of life relating to pruritus.
“The limited data that highlights regional and cultural variations in the impact of dermatological symptoms, such as quality of life relating to pruritus”
From Global Burden of Skin Disease: Inequities and Innovations (2017) · cites this paper as [13]
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- Authors
- Weisshaar, E., Apfelbacher, C., Jäger, G., Zimmermann, E., Bruckner, T., Diepgen, T. L., & Gollnick, H.
- Affiliations
- University Hospital Heidelberg (DE)
- Mbarara University of Science and Technology (UG)
- University Hospital Magdeburg (DE)
- Corresponding author
- Weisshaar, E.
- Venue
- British Journal of Dermatology
- Publisher
- Oxford University Press (OUP)
- Published
- 2006-07-11
- Volume
- 155
- Issue
- 5
- Pages
- 957-964
- ISSN
- 0007-0963 (ISSN-L)
- OpenAlex
- W1998114737
- Cited by
- 167
- References
- 29
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 3 · 2023: 6 · 2022: 8 · 2021: 10 · 2020: 13 · 2019: 13 · 2018: 12 · 2017: 9 · 2016: 12 · 2015: 9 · 2014: 10 · 2013: 5 · 2012: 14
- FWCI
- 7.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- British Journal of Dermatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Health Sciences › Medicine › Dermatology › Medicine and Dermatology Studies History
- Health Sciences › Medicine › Dermatology › Contact Dermatitis and Allergies
- Keywords
- pruritus, quality of life, skin diseases, prurigo, atopic dermatitis, depression, suicidal ideation, cross-cultural comparison, German patients, Ugandan patients
- MeSH terms
- Adolescent, Adult, Affect, Aged, Aged, 80 and over, Attitude to Health, Depression, Female, Germany, Humans, Male, Middle Aged, Pruritus, Quality of Life, Surveys and Questionnaires, Severity of Illness Index, Uganda, Black People, White People
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