• Junichi Hachisuka, Satoshi Takeuchi, Makiko Kido, Noriko Fukiwake, and Masutaka Furue.
• Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
• Int. J. Dermatol. 2009 Apr 1; 48 (4): 374-8.

BackgroundAtopic dermatitis (AD) is a chronic, relapsing skin disease characterized by xerosis and pruritus. As pruritus is an unpleasant sensation and the associated scratching aggravates the skin eruption considerably, it is important to control this symptom when treating AD. Dry skin is generally considered to be a potential cause of pruritus in xerotic skin diseases, but a clear correlation between pruritus and atopic xerosis has not been demonstrated. Aim To examine the contribution of atopic xerosis to the development of pruritus in AD.MethodsTwenty-two patients with AD (12 males and 10 females; mean age, 27.5 years) were examined. Xerosis and the severity of disease were evaluated using the Objective Severity Assessment of Atopic Dermatitis (OSAAD) and the SCORing Atopic Dermatitis (SCORAD) index, respectively. A modified SCORAD index was calculated by removing the symptoms potentially associated with pruritus (intensity of itching and insomnia) from the standard SCORAD index. Pruritus was evaluated using both a visual analog scale and the Verbal Itch Score.ResultsThe severity of AD (modified SCORAD index) correlated better than atopic xerosis (OSAAD score) with both pruritus scores, possibly indicating that the use of appropriate anti-inflammatory agents may be helpful in controlling pruritus as well as skin eruption in AD.ConclusionOur data suggest that the severity of disease (or skin inflammation) provides a greater contribution than xerosis to the development of pruritus in AD.

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