The experience of itch in children with psoriasis: A qualitative exploration of the Itch Numeric Rating Scale

Sally Mannix*, Emily Edson-Heredia, Amy S. Paller, Gil Yosipovitch, Russel Burge, Leah Kleinman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background/Objectives: Psoriasis is a chronic, immune-mediated dermatologic disorder with a prevalence among children estimated at 0.1%–0.45%, and a median age of onset at approximately 7–10 years. Pediatric psoriasis is known to have negative impacts on health-related quality of life. Among the most bothersome symptoms, itch has been measured using the Itch Numeric Rating Scale (NRS). This study explored the symptom and impacts of itch with pediatric psoriasis patients and evaluated the content validity of the Itch NRS in children. Methods: Semi-structured qualitative interviews were conducted among a sample of pediatric patients diagnosed with plaque psoriasis. Results: Concept elicitation interviews were completed with 22 children (ages 7–17 years). When asked about most frequent symptoms, 61% reported itching (n = 14) and 65% reported flaking (n = 15). The majority reported itching as bothersome; about half described impacts on their regular activities. Cognitive interviews were completed with 25 children (ages 8–17 years). Most reported that independently completing the Itch NRS would be easy, and all described the meaning of the response options similar to the intended value. Overall, the Itch NRS was received favorably, with comments that the scale was easy or relevant to their experience with psoriasis. Conclusions: This qualitative study supports the content validity of the Itch NRS for use in a pediatric psoriasis population aged 8–17. Given the established importance of itch to pediatric psoriasis patients, future research exploring the impact of itch on the lives of pediatric psoriasis patients may provide a valuable contribution to the field.

Original languageEnglish (US)
Pages (from-to)405-412
Number of pages8
JournalPediatric dermatology
Volume38
Issue number2
DOIs
StatePublished - Mar 1 2021

Funding

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or presentation of this manuscript: Emily E. Heredia and Russel Burge are employees and stockholders of Eli Lilly and Company. Sally Mannix and Leah Kleinman are employees of Evidera, a consulting company that has received funding from Eli Lilly and Company in connection with the implementation of the study (Evidera employees work with a variety of companies and are explicitly precluded from accepting any payment or honoraria directly from them for services rendered). Amy S. Paller is an employee of Northwestern University and has been an investigator or consultant for AbbVie, Anaptysbio, Celgene, Eli Lilly, Galderma, Incyte, Janssen, Leo, Novartis, and Regeneron; Consultant with honorarium for Almirall, Amgen, Asana, Boehringer‐Ingelheim, Castle Creek, Celgene, Dermavant, Dermira, Eli Lilly, Exicure, Forte, Galderma, Lenus, Leo, MEDA Corp, Meiji Seika, Novan, Novartis, Pfizer, Regeneron, Sanofi‐Genzyme, Sol Gel, and UCB. Gil Yosipovitch is an employee of University of Miami, who has received honoraria as a consultant advisory board member and research support funded by Eli Lilly, Pfizer, Novartis, Galderma, Sanofi Regeneron, Trevi, Menlo, Kiniksa, Leo Pharma, and Sun Pharmaceutical Industries. This study was funded by Eli Lilly and Company. Thank you to the site staff who assisted with participant recruitment and to the participating patients and their parents. Thanks also to the following Evidera employees: Regina Buachie, Julia Ingram, and Cristina Abél, who assisted with implementing and running the study; Rodolfo Matos, Julia Ingram, Regina Buachie, Cristina Abél, Gordon Parola, and Kellie Washington, who conducted participant interviews; Stephen Gilliver, who provided medical writing support; and Janet Dooley, who assisted with editing and formatting. This study was funded by Eli Lilly and Company.

Keywords

  • pruritis
  • psoriasis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Dermatology

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