Special Interest Group (Def-SIG)

Definition of terms and classifications concerning chronic pruritus

The dramatic growth in membership of the International Forum for the Study of Itch (IFSI) is a reflection of developments in pruritus research and patient care. As the knowledge base expands, it becomes more and more important for clinicians and researchers to have a forum to discuss highly specific issues in depth. One issue is the precise definitions of terms describing various forms of pruritus. Language is dynamic and underlies adaptation and changes corresponding to the development of new techniques and lifestyle. Most of the terms currently used for different types of pruritus were created decades ago. In 2007, the IFSI published a clinical classification of pruritus (Ständer S, Weisshaar E, Mettang T, Szepietowski JC, Carstens E, Ikoma A, Bergasa N, Gieler U, Misery L, Wallengren J, Darsow U, Streit M, Metze D, Luger TA, Greaves MW, Schmelz M, Yosipovitch G, Bernhard J. Clinical classification of itch: A position paper of the International Forum for the Study of Itch. Acta Dermatol Venerol 2007, 87: 291-294) Please click here to open the pdf version of this paper. For further publicationson IFSI, we refer to the website of Acta Dermato-Venereologica, http://adv.medicaljournals.se/.
The discussion around the definition of a first version of the IFSI-clinical classification already showed that an in-depth discussion and formation of a Special Interest Group (SIG) is necessary. This SIG aims to keep in continuous discussion about terms and definitions. Results will be published on the homepage of IFSI as well in to be determined Journals after consensus has been achieved among the members.
If you are interested in receiving the summary of the actual Def-SIG consensus or to contribute certain comments, please send an email to sonja.staender@uni-muenster.de.

Consensus among participants already achieved for:

Acute pruritus: up to 6 weeks
Chronic pruritus: lasting for 6 weeks and longer
Somatoform pruritus: pruritus of psychosomatic / psychiatric origin
Pruritus sine materia: should no longer be used
Alternative: Pruritus of unknown origin, pruritus on non-inflamed / normal skin
Pruritus of unknown origin (PUO):
- can be used interchangeably with “Itch of undetermined pruritus (IUO)”
- should be used in patients were a) no diagnostic is performed and history does not suggest an origin of pruritus; b) in patients with unknown origin of pruritus after diagnostics
Senile pruritus: should no longer be used
Alternative: pruritus of advanced age, pruritus in the elderly

IFSI - Special Interest Group: Scoring Itch in Clinical Trials
(SIG-Scoring Itch)
New in 2009

Chronic pruritus is a multidimensional and subjective symptom. Patients report next to individual pruritus intensity, quality, localization, duration, course, and scratching behaviour also interindividual variations in impact on quality of life, reduction of sleep time and psychosomatic conse-quences. Most of these factors temporally influence the itch severity, es-pecially the itch intensity. To date, the most commonly used tool for self-report of itch intensity is the visual analogue scale (VAS). VAS is a graphic method to obtain an objective representation of the subjective symptom itch. Currently, several new interesting tools for the objective measurement of itch are under development or already validated. For example, the Ep-pendorf Itch Questionnaire (EIQ), questionnaire for coping with itch (“JKF”), pruritus-specific quality-of-life questionnaire (ItchyQoL) and Pa-tient Benefit Index for pruritus patients (PBI-P) are already available. The world wide growing number of clinical trials evaluating antipruritic potency of new developed substances demands the development of further new robust assessment tools to monitor the improvement of several pruritus parameters such as e.g. dynamic pruritus score (measuring quantitative itch reduction), improvement of sleep time or regression of pruritus related-anxiety and depression. This SIG aims to give recommendations for the use of measurement tools such as VAS in clinical trials and application of additional and new tools.

This SIG is open to every IFSI member and interested experts. To contribute to our discussion, you can fill in the questionnaire. Please send it back via mail (Prof. Dr. S. Ständer, Department of Dermatology, Uni-versity of Münster, Von-Esmarch-Str. 58, 48149 Münster, Germany) or email (sonja.staender@uni-muenster.de).

The launch meeting of the new SIG and discussion of the questionnaire re-sults will take place during the next IFSI meeting in Tokyo: October 26th, 08.00 – 09.00 am.