35226 Characterization of pain in prurigo nodularis: An online survey-based study

Abstract

Background: Prurigo nodularis (PN) is a chronic dermatosis characterized by intense pruritus. While itch in PN is well-characterized, there remains limited understanding of the experience of itch-related pain and patient-reported treatments. Methods: An anonymous online Qualtrics survey was developed and delivered to three international PN support groups from July to September 2021. The survey characterized patient-reported treatments for pain and used validated metrics to assess the severity of symptoms including the Douleur Neuropathique 4i questionnaire (DN4i), Short-form McGill Pain Questionnaire (SF-MPQ-2) and Worst Pain Numeric Rating Scale (WP-NRS). Results: A total of 94 patients completed the survey and met inclusion criteria. Approximately 89.4% of respondents were female with a mean (SD) age of 53.7 (12.9) years. PN-associated pain was a consistently reported symptom with 48.9% of respondents experiencing daily pain. The pain experienced by patients was also classified as moderate-to-severe based on the mean WP-NRS score (6.9 ± 2.6). To assess dimensions of pain, the DN4i and SF-MPQ-2 were used with the majority of respondents (53.2%) meeting criteria for neuropathic pain syndrome based on the DN4i. The mean SF-MPQ-2 score was 2.9 ± 2.2 with the mean neuropathic subscale score of 3.6 ± 1.8. Despite the prevalence of neuropathic pain, only 36.2% of respondents reported lifetime use of gabapentin, pregabalin or tricyclic antidepressants. Conclusions: Moderate-to-severe neuropathic pain is frequently experienced in PN patients. However, the use of medications to address these symptoms is limited. Greater awareness of itch-associated symptoms and medications aimed at alleviating such symptoms may improve quality of life in this patient population.