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Journal of the American Academy of Dermatology
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le jeudi 31 octobre 2019
Doi : 10.1016/j.jaad.2019.06.043
accepted : 19 June 2019
Validity and reliability of itch assessment scales for chronic pruritus in adults: A prospective multicenter study

Yong Hyun Jang, MD, PhD a, , Seok Min Kim, MD a, Dong Hyuk Eun, MD a, Kyung Duck Park, MD, PhD a, Gyeong-Hun Park, MD, PhD b, Byung-Soo Kim, MD, PhD c, Kapsok Li, MD, PhD d, Chang Ook Park, MD, PhD e, Hye One Kim, MD, PhD f, Hei Sung Kim, MD, PhD g, Min Soo Jang, MD, PhD h, Eun Jin Doh, MD i, Dong Hun Lee, MD, PhD i, Yang Won Lee, MD, PhD j, Do Won Kim, MD, PhD a, Seong-Jin Kim, MD, PhD k,
a Department of Dermatology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea 
b Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea 
c Pusan National University School of Medicine, Busan, Republic of Korea 
d Chung-Ang University College of Medicine, Seoul, Republic of Korea 
e Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea 
f Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea 
g Incheon St. Mary's Hospital, Department of Biomedicine & Health Sciences, The Catholic University of Korea, Incheon, Republic of Korea 
h Kosin University College of Medicine, Busan, Republic of Korea 
i Seoul National University College of Medicine, Seoul, Republic of Korea 
j Konkuk University School of Medicine, Seoul, Republic of Korea 
k Chonnam National University Medical School, Gwangju, Republic of Korea 

Correspondence to: Yong Hyun Jang, MD, PhD, (41944) Department of Dermatology, School of Medicine, Kyungpook National University, 130, Dongduk-ro, Jung-gu, Daegu 700-721, Republic of Korea.(41944) Department of DermatologySchool of MedicineKyungpook National University130, Dongduk-ro, Jung-guDaegu700-721Republic of Korea∗∗Seong-Jin Kim, MD, PhD, (61469) Department of Dermatology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju, Republic of Korea.(61469) Department of DermatologyChonnam National University Hospital42 Jebong-ro, Dong-guGwangjuRepublic of Korea

Several tools can provide a reliable and accurate evaluation of pruritus, including the visual analog scale (VAS), numeric rating scale (NRS), verbal rating scale (VRS), and multidimensional questionnaires such as the Itch Severity Scale (ISS). However, no single method is considered a gold standard.


We evaluated the validity and reliability of VAS, NRS, VRS, and ISS and their correlation with a pruritus-specific quality of life instrument, ItchyQoL.


A total of 419 patients (215 men and 204 women) with chronic pruritus (mean age, 46.58 years) recorded their pruritus intensity on VAS, NRS, VRS, and ISS. Retest reliability was analyzed in a second assessment 3 hours after the initial assessment. All participants answered ItchyQoL.


A strong correlation between VAS, NRS, and VRS was found. ISS showed a low intercorrelation validity with these tools. However, ISS was more strongly correlated with ItchyQoL. The retest reliability scores were similar for VAS, NRS, and VRS but lower than the scores obtained for ISS.


Limitations include patient heterogeneity and recall bias.


The assessment of pruritus is challenging because of the subjective symptoms and the multifactorial nature. Therefore, more studies are needed to determine the best strategy to assess itch intensity.

The full text of this article is available in PDF format.

Key words : atopic dermatitis, eczema, itch, pruritus, quality of life, urticaria

Abbreviations used : ISS, ItchyQoL, NRS, QoL, VAS, VRS

 Funding sources: This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI18C0308).
 Conflicts of interest: None disclosed.
 Reprints not available from the authors.

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