title: Clinical characteristics of pruritus in patients with scalp psoriasis and their relation with intraepidermal nerve fiber density.
abstract: BACKGROUND
  The scalp is frequently affected in psoriasis patients, and pruritus can adversely affect the quality of life of affected patients. Few studies have assessed pruritus in scalp psoriasis.
  
  
  OBJECTIVE
  To determine the correlation among the clinical characteristics of pruritus, psoriasis scalp severity index (PSSI), and intraepidermal nerve fiber (IENF) density in psoriatic scalp lesions.
  
  
  METHODS
  Eighty patients (53 men, 27 women; mean age, 46.4 years; mean PSSI, 19.9) with scalp psoriasis were evaluated by using the PSSI and the Leuven itch scale. Biopsies were obtained from the lesional and nonlesional skin of 19 patients (10 men, 9 women; mean age, 37.8 years; mean PSSI, 25.8). Immunofluorescence staining of protein gene product 9.5 was performed to determine the IENF density.
  
  
  RESULTS
  Sixty-four patients (80%) complained of pruritus associated with scalp psoriasis, which negatively affected their quality of life to varying degrees. A moderate positive relation between PSSI score and pruritus intensity was identified (r=0.225 and p=0.044). The IENF density in psoriatic lesions was significantly higher than that in the nonlesional scalp (6.2±1.2 vs. 4.2±1.6, p<0.001). However, the correlations between IENF density and PSSI score, and IENF density and pruritus intensity were insignificant.
  
  
  CONCLUSIONS
  These results indicate that pruritus prevalence is high in patients with scalp psoriasis, and pruritus considerably influences the patients' daily lives and quality of life. In addition, high IENF density in psoriatic scalp lesions may play a role in the development of pruritus in scalp psoriasis.
authors.affiliation: Department of Dermatology, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Tae-Wook
authors.initials: TW
authors.lastname: Kim
authors.affiliation: Department of Dermatology, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Woo-Haing
authors.initials: WH
authors.lastname: Shim
authors.affiliation: Department of Dermatology, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Joung-Min
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Department of Dermatology, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Je-Ho
authors.initials: JH
authors.lastname: Mun
authors.affiliation: Department of Dermatology, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Margaret
authors.initials: M
authors.lastname: Song
authors.affiliation: Department of Dermatology, Pusan National University School of Medicine, Busan, Korea.
authors.forename: Hoon-Soo
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Dermatology, Pusan National University School of Medicine, Busan, Korea. ; Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Hyun-Chang
authors.initials: HC
authors.lastname: Ko
authors.affiliation: Department of Dermatology, Pusan National University School of Medicine, Busan, Korea. ; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Moon-Bum
authors.initials: MB
authors.lastname: Kim
authors.affiliation: Department of Dermatology, Pusan National University School of Medicine, Busan, Korea. ; Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Byung-Soo
authors.initials: BS
authors.lastname: Kim
keywords: Nerve fibers; Pruritus; Psoriasis; Scale; Scalp dermatoses