title: Clinical characteristics of pruritus in chronic idiopathic urticaria.
abstract: BACKGROUND
  Although pruritus is a predominant symptom of chronic idiopathic urticaria (CIU) its clinical characteristics have not been explored.
  
  
  OBJECTIVE
  To characterize the clinical pattern and sensory and affective dimensions of the itch experience, utilizing a comprehensive itch questionnaire.
  
  
  METHODS
  A structured questionnaire based on the McGill pain questionnaire was used in 100 patients suffering from CIU randomly recruited from a tertiary referral centre.
  
  
  RESULTS
  All 100 patients recruited with CIU completed the questionnaire. In 68 patients pruritus appeared on a daily basis. Most patients experienced their pruritus at night and in the evening (n = 83), and 62 reported difficulty in falling asleep. Pruritus involved all body areas, but mostly the arms (n = 86), back (n = 78) and legs (n = 75). Accompanying symptoms were a sensation of heat in 45 patients and sweating in 15. Most patients (n = 98) were prescribed antihistamines (mainly sedating), of whom 34 experienced long-term relief. The sensation of itch was reported to be stinging (n = 27), tickling (n = 25) and burning (n = 23). Seventy-six patients found their pruritus bothersome, 66 annoying and 14 complained of depression. The itch intensity at its peak was more than double that felt after a mosquito bite. The worst itch scores of those who felt depressed were significantly higher than of those who did not (P = 0.018). There was a positive correlation between the sensory and affective scores during worst itch (P < 0.001).
  
  
  CONCLUSIONS
  This study describes the itch experienced in CIU, highlighting sensory and affective dimensions. The itch questionnaire was found to be a valuable tool for evaluating pruritus in CIU and its unique features.
authors.affiliation: National Skin Center, 1 Mandalay Road, 308205 Singapore. gil@nsc.gov.sg
authors.forename: G
authors.initials: G
authors.lastname: Yosipovitch
authors.forename: N
authors.initials: N
authors.lastname: Ansari
authors.forename: A
authors.initials: A
authors.lastname: Goon
authors.forename: Y H
authors.initials: YH
authors.lastname: Chan
authors.forename: C L
authors.initials: CL
authors.lastname: Goh
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000982:Antipruritics / Q000627:therapeutic use; D002908:Chronic Disease; D005260:Female; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology; D011537:Pruritus / Q000188:drug therapy / Q000209:etiology* / Q000534:rehabilitation; D011788:Quality of Life; D012678:Sensation Disorders / Q000209:etiology; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000209:etiology; D011795:Surveys and Questionnaires; D014581:Urticaria / Q000150:complications*
chemical_list: D000982:Antipruritics; D006634:Histamine H1 Antagonists