About ITCH-E
The origins of ITCH-E can best be traced back to necessity. More than 50 years ago, Emory Dermatology began to be a destination for patients with complex dermatological problems, being the only academic dermatology department in a city undergoing explosive growth in the latter portion of the 20th century. The focus on itch in particular developed as a partnership between Drs. Suephy Chen and Robert Swerlick almost 20 years ago. At that time, our understanding of itch, the epidemiology and impact, the mechanisms driving itch, and effective treatments, were rudimentary at best.
We noted that while patients might be referred for a wide range of skin issues, those with pruritic components to their skin diseases were over-represented. When we attempted to analyze these patients, in particular regarding the pruritic aspects of their diseases, we found the previous literature relating to etiology, workup, assessment tools, and treatment was sorely lacking.
Dr. Chen, having recently completed her formal training in outcomes research at Stanford, identified the need to develop validated assessment tools to measure itch in patients and the impact of itch on patient quality of life (QOL). She and Dr. Swerlick also began efforts to structure how information was collected from patients during routine clinical encounters. Subsequently, Dr. Chen also undertook a large study of itch in the Veteran population.
The product of these efforts has been twofold. First, the VA study efforts have greatly expanded our understanding of the frequency and impact of itch in a large population, further supporting our impressions that treatment of pruritus represents a large unmet need. In particular, itch impact appears to have a disparate impact on African Americans, both in the percent of patients affected and the QOL burden. The other product has been the development of a validated itch-specific toll to measure the impact of itch, the Itchy QOL.
Our efforts at Emory have been accompanied by concurrent efforts at other centers examining the basic science of itch, primarily using animal models and molecular biology to unravel the neurological pathways driving itch. Our efforts focusing on developing tools to measure itch impact in patients and the effect of treatments has served as an essential complement to the basic science work examining mechanisms mediating itch, and each of these elements now serves as the foundation to begin to translate these observations into expanded knowledge that will impact on patients affected by itch.
