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Autoimmune connective tissue diseases (ACTDs) are a wide range of diseases that are featured by immune dysregulation. They often have multisystem involvement with noticeable skin manifestations. One of the most common symptoms in these diseases is pruritus. Pruritus has a significant impact on the quality of life of patients.
A review study was done to illustrate the frequency, location, severity, and timing comparative to disease onset of pruritus in various ACTDs. A chart review of all patients was seen in the Rheumatology-Dermatology clinic at Massachusetts General Hospital.
Itch was a distressing symptom in 83% of dermatomyositis (DM), 61% of systemic lupus erythematosus (SLE) complained of itching, 59% of Sjogren syndrome (SJO) reported itching, 22% of systemic sclerosis (SSc) reported itching, and 60% of mixed connective tissue disease. In DM and SLE, itch corresponded the course of inflammatory skin manifestations in 83% and 45%, respectively. Itch in DM was more extreme and more treatment resistant in 12% of DM vs 1% in SLE. In comparison, itch in SSc and SJO occur later in the disease course, 86% vs 42%, respectively.
The review concluded that in all ACTDs, itch was common and is mostly under-evaluated and under treated. Pruritus is more common and severe in DM than in SLE. Also, pruritus treatment in ACTDs is challenging, and at times multi-modal therapy is necessary.
Source: Yahya A, Gideon P. S. Characterizing Pruritus in Autoimmune Connective Tissue Diseases. J Drugs Dermatol. 2019 Oct 1;18(10):995-998.