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Journal of the American Academy of Dermatology
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le mercredi 17 juillet 2013
Doi : 10.1016/j.jaad.2013.05.029
accepted : 26 May 2013
Itch as a patient-reported symptom in ambulatory care visits in the United States

Melissa Shive, MD, MPH a, c, Eleni Linos, MD, DrPH b, Timothy Berger, MD b, Mackenzie Wehner, MPhil b, d, Mary-Margaret Chren, MD b,
a School of Medicine, University of California, San Francisco, California 
b Department of Dermatology, University of California, San Francisco, California 
c Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts 
d Stanford University School of Medicine, Palo Alto, California 

Reprint requests: Mary-Margaret Chren, MD, Department of Dermatology, University of California, San Francisco, Mt Zion Cancer Research Bldg, 2340 Sutter St, Room N412, San Francisco, CA 94143-0808.

European studies have shown that itch is a widespread symptom, yet little is known about its frequency in the United States.


We sought to describe ambulatory care visits to clinicians in the United States for which itch was coded as a patient symptom.


This study uses retrospective data from the National Ambulatory Medical Care Survey from 1999 through 2009.


Itch was coded as a symptom for an average of 7 million visits per year or approximately 1% of all outpatient visits, which was nearly 40% of the number of visits for the symptom of low back pain. Patients seen in visits for itch were more likely to be black or Asian than other patients (20% vs 14%). They were also more likely than other patients to receive a new medication (68% vs 36%) and were over twice as likely to receive 2 or more new medications (31% vs 14%).


Secondary data sets may not optimally capture patient reports and some of the procedures or medications may have been ordered for reasons other than itch.


Visits to clinicians for itch represent a sizeable proportion of ambulatory care visits in the United States, and research on the epidemiology, treatments, and causes of itch should be a priority.

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

Key words : clinic, clinic visits, epidemiology, itch, National Ambulatory Medical Care Survey, outpatient, pruritus, quality of life, skin

 Supported in part by a grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health (K24 AR052667, Dr Chren).
 Disclosure: Dr Chren serves as a consultant to Genentech Inc and Dr Berger serves as a consultant to Prescription Solutions. Dr Shive, Dr Linos, and Ms Wehner have no conflicts of interest to declare.
 Presented in abstract form at the symposium entitled Scratching the Surface: Frontier in Itch from Skin to Brain at Washington University in St Louis, September 2012.

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