J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 3, Number 5, October 2011, pages 223-229

Pruritus as Reason for Encounter in General Practice

**Table 1.** Patient Distribution* (pd) on Different Age Groups and Consultation Prevalence** (cp) of Pruritus in Different Age Groups of the German SESAM 2 Study and the Dutch Transition Project Concerning the Condition of New or Previously Known Pruritus in a General Practice Setting
Age (years)	SESAM 2 study (n = 64)	Transition Project initial consultation for new occurred pruritus (n = 5163)	Transition Project subsequent consultation for previously known pruritus (n = 1854)
Patient distribution (pd) is the percentage of the specified age group of the patients with pruritus (e.g. 7.8% of all SESAM 2-patients with pruritus were 5 to 14 years old); *Consultation prevalence (cp) is the percentage of patients with pruritus in the age group related to all patients of the age group (e.g. among SESAM 2-children from 5 to 14 years of age 1.7% encounter for pruritus).
0 to 4	3.1	1.8	4.9	2.6	4.5	0.9
5 to 14	7.8	1.7	9.3	3.3	7.1	0.9
15 to 24	6.3	0.4	11.6	3.7	8.2	0.9
25 to 44	15.6	0.5	32.0	3.6	29.4	1.2
45 to 64	34.4	0.8	21.1	3.3	20.1	1.1
65 to 74	14.1	0.5	11.5	3.7	16.3	1.9
> 75	18.8	1.0	9.6	3.4	14.4	1.8

Table 1. Patient Distribution* (pd) on Different Age Groups and Consultation Prevalence** (cp) of Pruritus in Different Age Groups of the German SESAM 2 Study and the Dutch Transition Project Concerning the Condition of New or Previously Known Pruritus in a General Practice Setting

Age (years)

SESAM 2 study
(n = 64)

Transition Project initial consultation for new occurred pruritus
(n = 5163)

Transition Project subsequent consultation for previously known pruritus
(n = 1854)

pd (%)

cp (%)

pd (%)

cp (%)

pd (%)

cp (%)

*Patient distribution (pd) is the percentage of the specified age group of the patients with pruritus (e.g. 7.8% of all SESAM 2-patients with pruritus were 5 to 14 years old); **Consultation prevalence (cp) is the percentage of patients with pruritus in the age group related to all patients of the age group (e.g. among SESAM 2-children from 5 to 14 years of age 1.7% encounter for pruritus).

0 to 4

3.1

1.8

4.9

2.6

4.5

0.9

5 to 14

7.8

1.7

9.3

3.3

7.1

0.9

15 to 24

6.3

0.4

11.6

3.7

8.2

0.9

25 to 44

15.6

0.5

32.0

3.6

29.4

1.2

45 to 64

34.4

0.8

21.1

3.3

20.1

1.1

65 to 74

14.1

0.5

11.5

3.7

16.3

1.9

> 75

18.8

1.0

9.6

3.4

14.4

1.8

**Table 2.** Physician’s Action (%) in the SESAM 2 Study and the Transition Project Concerning the Condition of New or Already Known Pruritus. Procedures That Are Not Explicit Diagnostic Were Also Registered in Table 3
Physician’s action	SESAM 2 study (n = 64)	Transition Project initial consultation for new occurred pruritus (n = 5163)	Transition Project subsequent consultation for previously known pruritus (n = 1854)
pc: primary care; *sc: specialized care.
Physical examination	100.0	92.7	86.0
Follow up consultation	75.0	N/A	N/A
Laboratory investigations	15.6	4.1	6.6
Referral	14.1	0.05 (pc*)	0.2 (pc*)
Other diagnostics	6.3	0.35	0.7
ECG	3.1	N/A	N/A
Hospitalization	1.6	1.6 (sc**)	9.1 (sc**)
Excision/histology	0	0.3	0.3

Table 2. Physician’s Action (%) in the SESAM 2 Study and the Transition Project Concerning the Condition of New or Already Known Pruritus. Procedures That Are Not Explicit Diagnostic Were Also Registered in Table 3

Physician’s action

SESAM 2 study
(n = 64)

Transition Project initial consultation for new occurred pruritus
(n = 5163)

Transition Project subsequent consultation for previously known pruritus
(n = 1854)

*pc: primary care; **sc: specialized care.

Physical examination

100.0

92.7

86.0

Follow up consultation

75.0

N/A

Laboratory investigations

15.6

4.1

6.6

Referral

14.1

0.05 (pc*)

0.2 (pc*)

Other diagnostics

6.3

0.35

0.7

ECG

3.1

N/A

Hospitalization

1.6

1.6 (sc**)

9.1 (sc**)

Excision/histology

0.3

**Table 3.** Physician’s Action (%) in the SESAM 2 Study and the Transition Project Concerning the Condition of New or Already Known Pruritus. Procedures That Are Not Explicitly Therapeutic Were Also Registered in Table 2
Physician’s action	SESAM 2 study (n = 64)	Transition Project initial consultation for new occurred pruritus (n = 5163)	Transition Project subsequent consultation for previously known pruritus (n = 1854)
pc: primary care; *sc: specialized care.
Drug prescription	84.4	84.3	79.0
Follow up consultation	75.0	N/A	N/A
Other therapy	20.3	0.6	1.0
Physicians advice	10.9	20.1	19.3
Referral	14.1	0.05 (pc*)	0.2 (pc*)
Incapacity to work	3.1	N/A	N/A
Hospitalization	1.6	1.6 (sc**)	9.1 (sc**)

Table 3. Physician’s Action (%) in the SESAM 2 Study and the Transition Project Concerning the Condition of New or Already Known Pruritus. Procedures That Are Not Explicitly Therapeutic Were Also Registered in Table 2

Physician’s action

SESAM 2 study
(n = 64)

Transition Project initial consultation for new occurred pruritus
(n = 5163)

Transition Project subsequent consultation for previously known pruritus
(n = 1854)

*pc: primary care; **sc: specialized care.

Drug prescription

84.4

84.3

79.0

Follow up consultation

75.0

N/A

Other therapy

20.3

0.6

1.0

Physicians advice

10.9

20.1

19.3

Referral

14.1

0.05 (pc*)

0.2 (pc*)

Incapacity to work

3.1

N/A

Hospitalization

1.6

1.6 (sc**)

9.1 (sc**)

**Table 4.** Comparing the Incidence (Number (N) and Percentage (%)) of Results of Encounter or Diagnoses in General Practice Patients With Pruritus to Those Without Pruritus (SESAM 2 Study) Shows That Pruritus is Significantly Associated to Skin Diseases
Diagnosis*	Pruritus	Without Pruritus	p-value (Fisher)
Further diagnoses of patients with pruritus omitted from the table because of lacking significance: Other infectious disease, gastrointestinal infection, anal fissure/perianal abscess, otitis externa, postural hypotension, neck symptom/complaint, fracture: hand/foot bone, bursitis/tendinitis/synovitis, tennis elbow, other musculoskeletal disease, Vertigo/dizziness, upper respiratory infection acute, Acute bronchitis/bronchiolitis, warts, Skin infection other, and cystitis/urinary infection. Dermatophytosis: A superficial fungus infection involving the stratum corneum of the skin, hair, and nails; **Urticaria: A pruritic skin eruption characterized by transient wheals of varying shapes and sizes with well-defined erythematous margins and pale centers.
Contact dermatitis	15	23.4	49	0.6	0.000
Dermatophytosis**	5	7.8	25	0.3	0.000
Herpes Zoster	5	7.8	21	0.2	0.000
Allergy/allergic reaction	4	6.3	10	0.1	0.000
Urticaria***	3	4.7	5	0.1	0.000
Scabies/Pediculosis	3	4.7	4	0	0.000
Varicella	3	4.7	8	0.1	0.000
Skin injury other	3	4.7	96	1.1	0.034
Atopic dermatitis	2	3.1	4	0	0.001
Atherosclerosis/peripheral vascular disease	2	3.1	10	0.1	0.003
Pruritus (not explained)	1	1.6	1	0	0.014
Adverse effect medical	1	1.6	1	0	0.014
Exanthema	1	1.6	1	0	0.014
Risk factor	1	1.6	2	0	0.021
Other viral exanthem	1	1.6	5	0.1	0.042
Perianal itching	1	1.6	1	0	0.014
Phobia/compulsive disorder	1	1.6	3	0	0.029
Seborrheic dermatitis	0	0	9	0.1	N/A
Psoriasis	0	0	8	0.1	N/A
Sun burn	0	0	15	0.2	N/A

Table 4. Comparing the Incidence (Number (N) and Percentage (%)) of Results of Encounter or Diagnoses in General Practice Patients With Pruritus to Those Without Pruritus (SESAM 2 Study) Shows That Pruritus is Significantly Associated to Skin Diseases

Diagnosis*

Pruritus

Without Pruritus

p-value
(Fisher)

*Further diagnoses of patients with pruritus omitted from the table because of lacking significance: Other infectious disease, gastrointestinal infection, anal fissure/perianal abscess, otitis externa, postural hypotension, neck symptom/complaint, fracture: hand/foot bone, bursitis/tendinitis/synovitis, tennis elbow, other musculoskeletal disease, Vertigo/dizziness, upper respiratory infection acute, Acute bronchitis/bronchiolitis, warts, Skin infection other, and cystitis/urinary infection. **Dermatophytosis: A superficial fungus infection involving the stratum corneum of the skin, hair, and nails; ***Urticaria: A pruritic skin eruption characterized by transient wheals of varying shapes and sizes with well-defined erythematous margins and pale centers.

Contact dermatitis

23.4

0.6

0.000

Dermatophytosis**

7.8

0.3

0.000

Herpes Zoster

7.8

0.2

0.000

Allergy/allergic reaction

6.3

0.1

0.000

Urticaria***

4.7

0.1

0.000

Scabies/Pediculosis

4.7

0.000

Varicella

4.7

0.1

0.000

Skin injury other

4.7

1.1

0.034

Atopic dermatitis

3.1

0.001

Atherosclerosis/peripheral vascular disease

3.1

0.1

0.003

Pruritus (not explained)

1.6

0.014

Adverse effect medical

1.6

0.014

Exanthema

1.6

0.014

Risk factor

1.6

0.021

Other viral exanthem

1.6

0.1

0.042

Perianal itching

1.6

0.014

Phobia/compulsive disorder

1.6

0.029

Seborrheic dermatitis

0.1

N/A

Psoriasis

0.1

N/A

Sun burn

0.2

N/A

**Table 5.** Frequency (%) of the Most Frequent Results of Encounter or Diagnoses for Primary Care Patients With a Complaint of Pruritus
Diagnosis	SESAM 2 study (n=64)	Transition Project initial consultation for new occurred pruritus (n = 5163)	Transition Project subsequent consultation for previously known pruritus (n=1854)	BEACH study (n=2971) [16]
Contact dermatitis	26.6	24.4	27.8	30.7
Dermatophytosis	7.8	11.5	5.2	5.8
Atopic dermatitis, eczema	7.8	5.4	10.8	1.3
Herpes Zoster	7.8	0.8	0	0
Urticaria	4.7	9.9	6.3	8.0
Scabies, pediculosis	4.7	1.0	0.9	4.8
Varicella	4.7	0.3	0.1	0
Adverse effect medical	6.3	1.9	1.1	2.0
Pruritus (not explained)	1.6	20.0	22.6	11.6
Seborrheic dermatitis	1.6	3.5	5.0	5.5
Psoriasis	1.6	0.5	1.9	2.3
Allergy, allergic reaction	1.6	1.8	1.4	4.7
Other skin disease	3.1	2.3	2.4	3.5
Insect bite	0	0.9	0.2	2.6
Solar keratosis, sunburn	0	0	0	2.3

Table 5. Frequency (%) of the Most Frequent Results of Encounter or Diagnoses for Primary Care Patients With a Complaint of Pruritus

Diagnosis

SESAM 2 study
(n=64)

Transition Project initial consultation for new occurred pruritus
(n = 5163)

Transition Project subsequent consultation for previously known pruritus
(n=1854)

BEACH study
(n=2971) [16]

Contact dermatitis

26.6

24.4

27.8

30.7

Dermatophytosis

7.8

11.5

5.2

5.8

Atopic dermatitis, eczema

7.8

5.4

10.8

1.3

Herpes Zoster

7.8

0.8

Urticaria

4.7

9.9

6.3

8.0

Scabies, pediculosis

4.7

1.0

0.9

4.8

Varicella

4.7

0.3

0.1

Adverse effect medical

6.3

1.9

1.1

2.0

Pruritus (not explained)

1.6

20.0

22.6

11.6

Seborrheic dermatitis

1.6

3.5

5.0

5.5

Psoriasis

1.6

0.5

1.9

2.3

Allergy, allergic reaction

1.6

1.8

1.4

4.7

Other skin disease

3.1

2.3

2.4

3.5

Insect bite

0.9

0.2

2.6

Solar keratosis, sunburn

2.3