Table Info

Table 1.

The 5-D itch questionnaire assessing the impact of itch on a daily function

5-D itch scale dimension			Total number of patients/frequency (n = 41)	Percentage %	*^P-value**
Duration of pain	> 6 h		24	58.50	0.71
	6–12 h		12	29.30
	12–18 h		0	0
	18–23 h		1	2.40
	All day		4	9.80
Degree of itch	Not		0	0	0.58
	Mild		18	43.90
	Mod		18	43.90
	Sever		5	12.20
	Unbearable		0	0
Direction of itch	Completely resolved		0	0	0.65
	Much better but still present		0	0
	A little bit better, but still present		0	0
	Unchanged		38	92.70
	Getting worse		3	7.30
Disability	Sleep	Never effect sleep	36	87.80	0.82
		Occasionally delays falling asleep	0	0
		Frequently delays falling asleep	3	7.30
		Delay falling asleep and occasionally wakes me up at night	2	4.90
		Delay falling asleep and frequently wakes me up at night	0	0
	Function	Never affect this activity	0	0	0.86
		Rarely affects this activity	36	87.80
		Occasionally affects this activity	4	9.80
		Frequently affects this activity	0	0
		Always affects this activity	1	2.40
Distribution^#	Face		4	9.80	0.12
	Chest		6	14.60
	Back		5	12.20
	Thigh		4	9.80
	Legs		7	17.10
	Soles		19	46.30
	Groin		4	9.80

^* Significance values represent the P-value from a Fisher’s exact test comparing the distribution of responses in each category; ^# Among the 41 patients, some patients have more than one itching location

Declarations

Acknowledgments

We extend our appreciation to the Pain Management team at HMC for their valuable assistance in collecting part of additional data throughout the study period.

Author contribution

WS: Conceptualization, Methodology, Investigation, Formal analysis, Resources, Writing—original draft. MM: Conceptualization, Validation, Writing—review & editing. Both authors read and approved the submitted version.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The study is approved by the ethical committee of both the anesthesiology department and the Hamad medical corporation board (approval no. CA00003/2019). The study took place from January 1st to March 31st, 2019 and was conducted in accordance with the Declaration of Helsinki.

Consent to participate

Informed consent to participate in the study was obtained from all participants.

Consent to publication

Not applicable.

Availability of data and materials

Not applicable.

Funding

Not applicable.

Copyright

References

Yosipovitch G, Greaves MW, Schmelz M. Itch. Lancet. 2003;361:690–4. [DOI] [PubMed]

Scholz J, Finnerup NB, Attal N, Aziz Q, Baron R, Bennett MI, et al.; Classification Committee of the Neuropathic Pain Special Interest Group (NeuPSIG). The IASP classification of chronic pain for ICD-11: chronic neuropathic pain. Pain. 2019;160:53–9. [DOI] [PubMed] [PMC]

Schmelz M. Itch and pain differences and commonalities. Handb Exp Pharmacol. 2015;227:285–301. [DOI] [PubMed]

Freynhagen R, Baron R. The evaluation of neuropathic components in low back pain. Curr Pain Headache Rep. 2009;13:185–90. [DOI] [PubMed]

Ständer S, Weisshaar E, Mettang T, Szepietowski JC, Carstens E, Ikoma A, et al. Clinical classification of itch: a position paper of the International Forum for the Study of Itch. Acta Derm Venereol. 2007;87:291–4. [DOI] [PubMed]

Oaklander AL. Neuropathic itch. Semin Cutan Med Surg. 2011;30:87–92. [DOI] [PubMed] [PMC]

Cohen OS, Chapman J, Lee H, Nitsan Z, Appel S, Hoffman C, et al. Pruritus in familial Creutzfeldt-Jakob disease: a common symptom associated with central nervous system pathology. J Neurol. 2011;258:89–95. [DOI] [PubMed]

Oaklander AL. Common neuropathic itch syndromes. Acta Derm Venereol. 2012;92:118–25. [DOI] [PubMed]

Sreekantaswamy SA, Mollanazar N, Butler DC. Gabapentinoids for pruritus in older adults: a narrative review. Dermatol Ther (Heidelb). 2021;11:669–79. [DOI] [PubMed] [PMC]

10.

Merskey H, Bogduk N. Classification of chronic pain. 2nd ed. Seattle: IASP Press; 1994.

11.

Elman S, Hynan LS, Gabriel V, Mayo MJ. The 5-D itch scale: a new measure of pruritus. Br J Dermatol. 2010;162:587–93. [DOI] [PubMed] [PMC]

12.

Dalgard F, Dawn AG, Yosipovitch G. Are itch and chronic pain associated in adults? Results of a large population survey in Norway. Dermatology. 2007;214:305–9. [DOI] [PubMed]

13.

Ishikawa R, Iseki M, Koga R, Inada E. Investigation of the correlation between pstherpetic itch and neuropathic pain over time. Pain Res Manag. 2018;2018:9305126. [DOI] [PubMed] [PMC]

14.

Devigili G, Eleopra R, Pierro T, Lombardi R, Rinaldo S, Lettieri C, et al. Paroxysmal itch caused by gain-of-function Nav1.7 mutation. Pain. 2014;155:1702–07. [DOI] [PubMed]

15.

Baron R, Schwarz K, Kleinert A, Schattschneider J, Wasner G. Histamine-induced itch converts into pain in neuropathic hyperalgesia. Neuroreport. 2001;12:3475–8. [DOI] [PubMed]

16.

Ziccardi VB, Rosenthal MS, Ochs MW. Trigeminal trophic syndrome: a case of maxillofacial self-mutilation. J Oral Maxillofac Surg. 1996;54:347–50. [DOI] [PubMed]

17.

Šitum M, Kolić M, Franceschi N, Pećina M. Notalgia paresthetica. Acta Clin Croat. 2018;57:721–25. [DOI] [PubMed] [PMC]

18.

Ständer S, Schmelz M. Chronic itch and pain—similarities and differences. Eur J Pain. 2006;10:473–8. [DOI] [PubMed]

19.

Foroutan N, Etminan A, Nikvarz N, Shojai Shahrokh Abadi M. Comparison of pregabalin with doxepin in the management of uremic pruritus: a randomized single blind clinical trial. Hemodial Int. 2017;21:63–71. [DOI] [PubMed]

20.

Joo SY, Cho YS, Cho SR, Kym D, Seo CH. Effects of pain Scrambler therapy for management of burn scar pruritus: a pilot study. Burns. 2017;43:514–19. [DOI] [PubMed]

21.

Paul J. A cross-sectional study of chronic wound-related pain and itching. Ostomy Wound Manage. 2013;59:28–34. [PubMed]

22.

Eisenberg E, Barmeir E, Bergman R. Notalgia paresthetica associated with nerve root impingement. J Am Acad Dermatol. 1997;37:998–1000. [DOI] [PubMed]

23.

Oaklander AL, Cohen SP, Raju SV. Intractable postherpetic itch and cutaneous deafferentation after facial shingles. Pain. 2002;96:9–12. [DOI] [PubMed]

24.

Ward L, Wright E, McMahon SB. A comparison of the effects of noxious and innocuous counterstimuli on experimentally induced itch and pain. Pain. 1996;64:129–38. [DOI] [PubMed]

25.

Birklein F, Claus D, Riedl B, Neundörfer B, Handwerker HO. Effects of cutaneous histamine application in patients with sympathetic reflex dystrophy. Muscle Nerve. 1997;20:1389–95. [DOI] [PubMed]

26.

Ikoma A, Steinhoff M, Ständer S, Yosipovitch G, Schmelz M. The neurobiology of itch. Nat Rev Neurosci. 2006;7:535–47. [DOI] [PubMed]

27.

Oaklander AL, Fields HL. Is reflex sympathetic dystrophy/complex regional pain syndrome type I a small-fiber neuropathy? Ann Neurol. 2009;65:629–38. [DOI] [PubMed]

28.

Mishriki YY. A recalcitrant case of reflexive nose picking. Trigeminal trophic syndrome. Postgrad Med. 1999;106:175–6. [DOI] [PubMed]

29.

Setyadi HG, Cohen PR, Schulze KE, Mason SH, Martinelli PT, Alford EL, et al. Trigeminal trophic syndrome. South Med J. 2007;100:43–8. [DOI] [PubMed] [PMC]

30.

Sharif B, Ase AR, Ribeiro-da-Silva A, Séguéla P. Differential coding of itch and pain by a subpopulation of primary afferent neurons. Neuron. 2020;106:940–51. [DOI] [PubMed]