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K.L. Hon, J.S.C. Kung, M. Wang, N.H. Pong, A.M. Li, T.F. Leung, Clinical scores of sleep loss and itch, and antihistamine and topical corticosteroid usage for childhood eczema, British Journal of Dermatology, Volume 175, Issue 5, 1 November 2016, Pages 1076–1078, https://doi.org/10.1111/bjd.14660
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Funding sources: none.
Conflicts of interest: none declared.
Dear Editor, Childhood atopic dermatitis (AD) or eczema is a distressing disease associated with impaired quality of life. Sleep loss and itch are the cardinal symptoms. Various mechanisms of the pathophysiology of itch or pruritus have been proposed.1 Itch leads to scratching and sleep disturbance, which ultimately exacerbate eczema and further result in impaired quality of life and psychological symptomatology of stress, anxiety and even depression.2,3 Hence, the clinical evaluation of the two cardinal symptoms forms an important component of eczema assessment and in gauging clinical efficacy of treatment.
The severity of itch is traditionally assessed by questionnaires or visual analogue scales, both of which rely on the assumption that the subject or caregiver is able to relate the perceived experiences accurately.4,5 Itch can be measured by a number of surrogate markers, including serum brain‐derived neurotrophic factor and substance P.1,6 Scratching as a manifestation of itch can also be electronically measured, and correlates well with disease severity and impaired quality of life.7 Sleep disturbance or sleep loss is a consequence of the symptom of itch and scratching.6,7 Sleep loss is often measured by clinical scores. Its objective measurement by formal study of sleep efficiency is possible but time consuming.6,7,8 This study aims to investigate correlations among three clinical scores for sleep loss, pruritus, disease severity and quality of life.
