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The impact of prurigo nodularis on quality of life: a systematic review and meta-analysis

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Abstract

Prurigo nodularis (PN) is a chronic, pruritic, debilitating disease. Previous studies found that chronic pruritus in general negatively affects patients’ quality of life (QoL). However, results about the impact of PN on QoL are conflicting. Our objective was to assess the QoL burden of PN. A systematic review was conducted of all published studies that assessed QoL measures in PN. OVID MEDLINE, EMBASE, SCOPUS, and Web of Science were searched. Pooled meta-analysis (means) was performed using random-effects weighting. Overall, 13 studies met inclusion criteria. All studies identified QoL reductions in patients suffering from PN compared to control groups. The most common QoL instrument used was the Dermatology Life Quality Index [n = 9 studies; pooled mean (95% confidence interval): 13.8 (10.6–16.9), denoting a very large effect]. In particular, PN was associated with substantial impact on multiple domains of QoL. No publication bias was detected. In conclusion, QoL is negatively impacted in PN. Future studies are necessary to determine the best instruments of measuring QoL in PN patients, better understand this association, and assess the impact in males and females separately. PROSPERO CRD42019136193.

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Abbreviations

CI:

Confidence interval

Cohort:

Retrospective cohort study

DLQI:

Dermatology life quality index

EQ-5D-3L:

European quality of life 5 dimensions 3 levels

IFSI:

International Forum for the Study of Itch

ISDL:

Impact of skin disease on daily life

NOS:

Newcastle–Ottawa quality assessment scale

NRS-itch:

Numeric rating scale itch intensity (0–10)

PGS:

Pruritus grading scale

PLQ:

Pruritus life quality

PN:

Prurigo nodularis

PRISMA:

Preferred reporting items for systematic reviews and meta-analyses

QoL:

Quality of life

RCT:

Randomized controlled trial

RoB:

Risk of bias

SD:

Standard deviation

SR:

Systematic review

VAS-itch:

Visual analogue scale itch intensity (0–10 continuous)

VRS-itch:

Verbal rating score itch intensity (0–4)

YLD:

Years lived with disability

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Acknowledgements

We thank Dr. Yik Weng Yew for translations of Chinese language manuscripts.

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Authors and Affiliations

  1. Department of Dermatology, Universitair Ziekenhuis Brussel (UZB), Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090, Jette, Belgium

    Sherief R. Janmohamed

  2. Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA

    Eran C. Gwillim & Muhammad Yousaf

  3. Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Kevin R. Patel

  4. Department of Dermatology, George Washington University School of Medicine, 2150 Pennsylvania Avenue, Suite 2B-430, Washington, DC, 20037, USA

    Jonathan I. Silverberg

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  1. Sherief R. Janmohamed
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Contributions

JS had the idea for the article; SJ, EG, MY, and KP performed the literature search and data analysis; and SJ drafted and JS critically revised the work.

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Correspondence to Jonathan I. Silverberg.

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Janmohamed, S.R., Gwillim, E.C., Yousaf, M. et al. The impact of prurigo nodularis on quality of life: a systematic review and meta-analysis. Arch Dermatol Res 313, 669–677 (2021). https://doi.org/10.1007/s00403-020-02148-0

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