Special Interest Groups (SIGs) of the IFSI
The dramatic growth in publications and clinical trials related to chronic pruritus is a reflection of developments in associated research and patient care. As our knowledge expands, it becomes more and more important for clinicians and researchers to have a platform for small focus groups to discuss highly specific issues in depth. To accomplish this, various special interest groups (SIGs) have been founded by the International Forum for the Study of Itch (IFSI).
The SIGs aim to provide participating members an opportunity to carry on intensive, in-depth discussions in certain areas of interest. Membership in SIGs is open to any member of the IFSI. IFSI members wishing to join a SIG should indicate their preference by sending an e-mail to the IFSI office directly or, alternatively, to a SIG chair.
Some papers released by the SIG below can be found below. For further SIG publications, please refer to the website of Acta Dermato-Venereologica: http://adv.medicaljournals.se/.
- Definition of terms and classifications concerning chronic pruritus
- Scoring Itch in Clinical Trials
- Questionnaires for Itch
- Paraneoplastic Itch
- Uremic Itch
- Sensitive Skin
SIG: Definition of terms and classifications concerning chronic pruritus
Chair: S. Ständer, J.D. Bernhard
Language is dynamic and underlies adaptation and changes corresponding to the development of new techniques and lifestyles. Most of the terms currently used for different types of pruritus were created decades ago. In 2007, the IFSI created its first SIG and published a clinical classification of pruritus. Discussions on the definition of a first version of the IFSI’s clinical classification for pruritus had already shown that an in-depth discussion and formation of a Special Interest Group (SIG) was necessary. This SIG aims to generate continuous discussion about related terms and definitions. Results will be published on the homepage of the IFSI, as well as in journals (specific journals remain to be determined), after members have achieved a consensus.
Meetings: During WCI
Consensus among participants already achieved for:
- Acute pruritus: up to 6 weeks
Chronic pruritus: lasting 6 weeks or longer
- Somatoform pruritus: pruritus of psychosomatic/psychiatric origin
- Pruritus sine materia: should no longer be used
- Alternative: Pruritus of unknown/undetermined 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 for patients for which a) no diagnostics are performed and whose history does not suggest an origin for the pruritus; or b) in patients with pruritus of unknown origin post-diagnostics
- Senile pruritus: should no longer be used
Alternative: pruritus of advanced age, pruritus in the elderly
Ständer S, Weisshaar E, Mettang T, et al. 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.
European Guideline on Chronic Pruritus
In cooperation with the European Dermatology Forum (EDF) and the European Academy of Dermatology and Venereology (EADV). Please click here to open the .pdf version of this paper.
SIG: Scoring Itch in Clinical Trials
Chair: S. Ständer, J. Szepietowski, M. Augustin
Chronic pruritus poses a dilemma across the globe and there is an urgent need to test new anti-pruritic substances in high-quality clinical trials. It remains a multidimensional, subjective symptom for which there is no widely accepted, standardized and validated assessment method. Patients report on the individual pruritus intensity, quality, localization, duration, course, and scratching behavior, as well as provide interindividual variations regarding the impact on quality of life, sleep disturbances and psychosomatic factors results. This SIG was established to develop and validate scoring methods and questionnaires for use in clinical trials.
Meetings: During WCI
- Pereira MP, Ständer S. Assessment of severity and burden of pruritus. Allergol Int. 2017; 66: 3-7.
- Gernart M, Tsianakas A, Zeidler C, et al. ItchApp©: An App-based eDiary for Assessment of Chronic Pruritus in Clinical Trials. Acta Derm Venereol. 2016 in press
- Steinke S, Bruland P, Blome C, et al. Chronic pruritus: evaluation of patient needs and treatment goals with a special regard to differences according to pruritus classification and sex. Br J Dermatol. 2016. doi: 10.1111/bjd.14910. [Epub ahead of print]
- Ständer S, Blome C, Anastasiadou Z, et al. Dynamic pruritus score: evaluation of the validity and reliability of a new instrument to assess pruritus course. Acta Dermato Venereol 2016, in press doi: 10.2340/00015555-2494. [Epub ahead of print]
- Fritz F, Blome C, Augustin M, et al. Differences in patient and physician assessment of a dynamic patient reported outcome tool for chronic pruritus. J Eur Acad Dermatol Venereol. 2016; 30:962-5
- Reich A, Riepe C, Anastasiadou Z, et al. Itch Assessment with Visual Analogue Scale and Numerical Rating Scale: Determination of Minimal Clinically Important Difference in Chronic Itch. Acta Derm Venereol. 2016; 96:978-980.
- Ständer S, Augustin M, Reich A, Blome C, Ebata T, Phan NQ, Szepietowski JC; International Forum for the Study of Itch Special Interest Group Scoring Itch in Clinical Trials.. Pruritus assessment in clinical trials: consensus recommendations from the International Forum for the Study of Itch (IFSI) Special Interest Group Scoring Itch in Clinical Trials. Acta Derm Venereol. 2013; 93: 509-14
- Furue M, Ebata T, Ikoma A, et al. Verbalizing extremes of the visual analogue scale for pruritus: a consensus statement. Acta Derm Venereol. 2013; 93:214-5. Please click here to open the pdf version of this paper.
- Ständer S, Blome C, Breil B, et al. [Assessment of pruritus - current standards and implications for clinical practice : consensus paper of the Action Group Pruritus Parameter of the International Working Group on Pruritus Research (AGP)]. Hautarzt. 2012; 63: 521-2, 524-31.
- Phan NQ, Blome C, Fritz F, et al. Assessment of pruritus intensity: prospective study on validity and reliability of the visual analogue scale, numerical rating scale and verbal rating scale in 471 patients with chronic pruritus. Acta Derm Venereol. 2012; 92:502-7.
- Reich A, Heisig M, Phan NQ, et al. Visual analogue scale: evaluation of the instrument for the assessment of pruritus. Acta Derm Venereol. 2012; 92:497-501
- Blome C, Augustin M, Siepmann D, et al. Measuring patient-relevant benefits in pruritus treatment: development and validation of a specific outcomes tool. Br J Dermatol 2009; 161:1143-1148.
SIG: Questionnaires for Itch
Chair: Elke Weisshaar, Uwe Gieler, Gil Yosipovitch
The assessment of itch and its associated effects is a significant component of clinical practice in itch management. Despite itch being a common complaint, there are few studies describing the use of structured questionnaires for the evaluation and measurement of itch and its sensory and affective dimensions. This SIG was initiated to evaluate the various psychometric properties of itch questionnaires and to achieve consensus on an individual questionnaire to be used globally.
Meetings: During WCI
Weisshaar E, Gieler U, Kupfer J, et al. International Forum on the Study of Itch.. Questionnaires to assess chronic itch: a consensus paper of the special interest group of the International Forum on the Study of Itch. Acta Derm Venereol. 2012; 92:493-6
This first consensus paper addresses which domains and structure of itch questionnaires need to be implemented to better assess chronic itch and guideline-recommended therapies. Please click here to open the .pdf version of this paper.
SIG: Paraneoplastic Itch
Chair: Elke Weisshaar, Ben Zylicz
In clinical practice, the term “paraneoplastic itch” is used to describe itch in patients with cancer. Patients with hematological or solid tumor malignancies can also be affected. Paraneoplastic itch due to hematological malignancies such as polycythemia vera and lymphoma are relatively frequent, while other forms of paraneoplastic itch are, in fact, extremely rare. Itch in malignant diseases may additionally impair patients’ quality of life. In 2011, this SIG was founded with the aim to establish a clear definition of paraneoplastic itch.
Meetings: During WCI
Weisshaar E, Weiss M, Mettang T, et al. Special Interest Group of the International Forum on the Study of Itch.. Paraneoplastic itch: an expert position statement from the Special Interest Group (SIG) of the International Forum on the Study of Itch (IFSI). Acta Derm Venereol. 2015 Mar;95(3):261-5.
In this paper, we briefly review current knowledge on the topic and aim to define what can be summarized under the term “paraneoplastic itch”. Please click here to open the .pdf version of this paper.
SIG: Uremic Itch
Moderators: Thomas Mettang, Jacek C. Szepietowski
Uremic itch (UI) is a frequent and very excruciating symptom in patients with advanced or end-stage renal failure. UI consistently has a strong negative impact on the quality of life. The pathophysiology of UI is not well known. This SIG aims to increase the awareness of UI and create a platform for continuous exchange.
Meetings: During WCI
Mettang T. Uremic Itch Management. Curr Probl Dermatol. 2016;50:133-41. doi: 10.1159/000446056.
Mettang T, Kremer AE. Uremic pruritus. Kidney Int. 2015; 87: 685-91. doi: 10.1038/ki.2013.454.
SIG: Sensitive Skin
Chair: Laurent Misery
Sensitive skin is a frequent complaint in the general population and among patients with itch. The International Forum for the Study of Itch (IFSI) decided to initiate a special interest group (SIG) for sensitive skin. Using the Delphi method, sensitive skin was defined as "a syndrome defined by the occurrence of unpleasant sensations (stinging, burning, pain, pruritus and tingling sensations) in response to stimuli that normally should not provoke such sensations. These unpleasant sensations cannot be explained by lesions attributable to any skin disease. The skin can appear normal or be accompanied by erythema. Sensitive skin can affect all body locations, especially the face". This paper summarizes the background and unresolved aspects of sensitive skin, as well as the process involved in the development of this definition.
Meetings: During WCI
Misery L, Ständer S, Szepietowski JC, et al. Definition of Sensitive Skin: An Expert Position Paper from the Special Interest Group on Sensitive Skin of the International Forum for the Study of Itch. Acta Derm Venereol. 2017; 96: 4-6
Misery L, Loser K, Ständer S. Sensitive skin. J Eur Acad Dermatol Venereol. 2016; 30 Suppl 1:2-8
Buhé V, Vié K, Guéré C, et al . Pathophysiological Study of Sensitive Skin. Acta Derm Venereol. 2016; 96: 314-8.
Saint-Martory C, Sibaud V, Theunis J, et al. Arguments for neuropathic pain in sensitive skin. Br J Dermatol. 2015; 172: 1120-1.