PS59 Itch, psychological issues and life-quality impairment in adverse skin reactions due to antitumour therapy in comparison with atopic dermatitis and melanoma in a multicentre cross-sectional, observational study

Abstract

The impact of adverse skin reactions to antitumour therapy (ASR) on psychological characteristics is underinvestigated. We evaluated itch and the psychological status of patients with ASR in comparison with patients with atopic dermatitis (AD) or melanoma. This was a multicentre cross-sectional, observational study of dermatological outpatients from three clinics. Patients with ASR (n = 93), atopic dermatitis (AD) (n = 106) and psoriasis (n = 101) and healthy volunteers (n = 216) were included. Itch intensity was measured with a visual analogue scale (VAS). Psychometric examination comprised scales for anxiety (General Anxiety Disorder-2), depression (Patient Health Questionnaire-2), perceived stress (Perceived Stress Sscale-10, PSS-10), perceived stigmatization (Perceived Stigmatization Questionnaire, PSQ) and quality of life (5-Pruritus Life Quality, 5PLQ). AD and ASR did not differ from each other significantly in itch frequency (71.7% and 66%), VAS itch intensity [median 6.0, interquartile range (IQR) 3.8–8.0 and median 5.0, IQR 4.0–7.0], 5PLQ score (median 7.0, IQR 3.0–9.0 and median 6.00, IQR 3.0–11.0), PSQ score (median 14.0, IQR 10.0–25.0 and median 15.0, IQR 8.0–26.0) or PSS-10 score (median 18.0, IQR 14.0–22.0 and median 18.5, IQR 15.0–23.0). However, both AD and ASR showed significantly higher parameters than melanoma for itch frequency (15.9% for melanoma), VAS itch intensity (median 2.0, IQR 1.0–2.0; P = 0.001), 5PLQ score (median 1.0, IQR 0.0–3.0; P = 0.001), PSQ score (median 11.0, IQR 7.0–17.0; P = 0.006) or PSS-10 score (median 12.0, IQR 8.0–18.0). Anxiety and depression (General Health Questionnaire-4 score) ranged from the highest score (median and IQR) in AD (4.0, 3.0–6.8) to the lowest in skin melanoma (1.0, 0.0–3.0), with an intermediate score for ASR (2.0, 2.0–5.0; P < 0.001). ASR is characterized by a high prevalence and intensity of itch, impact of itch on quality of life, stigmatization and stress, and the increased levels of anxiety and depression. These are comparable with severe pruritic dermatosis such as AD. The management of patients with ASR should address associated psychological issues and itch.