Itch in patients with cutaneous T-cell lymphoma as a quality of life indicator

Rosanne Ottevanger; Sylvia van Beugen; Andrea W M Evers; Rein Willemze; Maarten H Vermeer; Koen D Quint

doi:10.1016/j.jdin.2022.07.007

Itch in patients with cutaneous T-cell lymphoma as a quality of life indicator

JAAD Int. 2022 Aug 7:9:57-64. doi: 10.1016/j.jdin.2022.07.007. eCollection 2022 Dec.

Authors

Rosanne Ottevanger¹, Sylvia van Beugen², Andrea W M Evers², Rein Willemze¹, Maarten H Vermeer¹, Koen D Quint¹

Affiliations

¹ Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands.
² Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands.

Abstract

Background: Cutaneous T-cell lymphoma (CTCL) is a chronic and progressive disease that has a major impact on quality of life (QoL).

Objectives: To describe the impact of the different stages of disease in patients with classical mycosis fungoides, folliculotropic mycosis fungoides, and Sézary syndrome on generic- and dermatology-specific QoL and the relation with itch.

Methods: A cross-sectional cohort study of patients with classical mycosis fungoides, folliculotropic mycosis fungoides, and Sézary syndrome was performed. Outcomes were the Skindex-29 score, Impact of Chronic Skin Disease on Daily Life which includes a visual analogue scale itch, and RAND-12.

Results: One hundred six patients with CTCL were included. Compared to the total mycosis fungoides group, patients with Sézary syndrome had significantly worse Skindex-29 scores. Patients with advanced disease had statistically higher scores for the symptom (P = .007), functioning (P = .002), and total score (P = .012). The degree of itching was strongly correlated with the total Skindex-29 score (R = 0.713, P < .001).

Conclusion: The different stages of CTCL can have a significant effect on multiple domains of generic- and dermatology-specific QoL. Itch was strongly correlated with QoL and therefore can be used as an overall QoL indicator. The effect on QoL, even in patients with early-stage disease, should not be underestimated.

Keywords: CCI, classic Charlson comorbidity index; CTCL, cutaneous T-cell lymphoma; FMF, folliculotropic mycosis fungoides; MF, mycosis fungoides; PCS, physical component score; Qol, quality of life; RAND-12; SS, sézary syndrome; STROBE, Strengthening the Reporting of Observational studies in Epidemiology; Skindex-29; Sézary syndrome; cMF, classical MF; cutaneous T-cell lymphoma; itch; mycosis fungoides; quality of life.