LB1101 Itch and quality of life impact in atopic dermatitis vs bullous pemphigoid

Atopic dermatitis (AD) and bullous pemphigoid (BP) are inflammatory skin diseases in which patients often report intense pruritus and significant quality of life (QOL) impact. Although they have differences in classical presentation (eczematous eruption versus urticaria and blisters) and population characteristics (young-to middle aged persons vs. elderly), early stages of BP can appear similar to AD clinically and histologically. We wanted to explore whether there were significant similarities or differences in pruritus characteristics and QOL impact. Our observational cohort study included 65 patients with either AD (34) or BP (31) and a history of chronic pruritus. Our cohort was mostly female (66%), mean ages 47.1 (AD) and 72.2 (BP), mean severity scores 38.5 (AD, EASI) and 19.4 (BP, BPDAI). We assessed QOL and itch severity using the QOL from pruritus (ItchyQoL) and cartoon-annotated 11-point rating scale (ItchyQuant) questionnaires. The mean total ItchyQoL scores for AD and BP were 48.8 (mild) and 44.4 (mild), respectively. Furthermore, the ItchyQoL totals were subdivided into symptom, function and emotional impact components. We did not find meaningful differences between total or category itch scores in AD vs. BP. The only significant differences between itch characteristics were the aggravation of skin by seasonal/temperature changes and feelings of self-consciousness (p=0.002), both of which were higher reported by patients with AD. Itch severity was taken into account using the ItchyQuant scale. Considering a 0-10 severity scale, the mean scores for AD and BP were 5.23 and 5.90, respectively, which was also not found to be significantly different. This study was limited by the relatively small sample size. To our knowledge, no other study has sought to compare itch directly between different chronic pruritic diseases. Given the similarity in patient-reported itch outcomes, patients with chronic itch may have shared experiences and quality of life impact, warranting further research into possible commonalities of their underlying disease pathways.