TABLE 4.
Consequences of itchiness in patients with psoriasis
| Category | Results | Quotes |
|---|---|---|
| Physical | Bleeding/open sores from scratching | “She would, like, scratch herself so bad she’d bleed. She would, like, take a bath, and the bath would be covered in blood. It was bad.” FG5 FM2 50–51* |
| Infection | “If I scratch them [the plaques] a lot and they bleed, they would sometimes get infected.” FG2 P6 160–161 | |
| Emotional well-being | Depression | “Honestly, [it makes me] very, very depressed […] I guess you could say.” IT2 P 60 |
| Labile emotions | “My wife gets mood swings bad. When she is itchy, it’s like, ‘Stay out of her way!’" FG5 FM1 176 | |
| Anger/short temper | “[I’ve made] comments like, ‘We really need to vacuum,’ you know [...], not realizing how sensitive he might be about it. And so now, I don’t comment about that anymore, and if I see flakes […]. I feel like I have to be cautious right now, because it’s so bad in the house, making those kinds of comments.” IT5 FM 89–90,105–106 | |
| Inability to relax | “When I am not active and not doing other things [to take my mind off the itchiness] and at home trying to relax and then I realize how much itching I have going on, and I can’t stop, sometimes, the scratching.” IT2 P 12–14 | |
| Sleeping | Difficulty sleeping | “It generally affects the sleep—it seems to me [...] instead of getting eight hours, I might get three hours here and then come home and take a nap. [...] It seems like I can't remember the last time I slept eight hours in a row. So it definitely [...] affects my sleep.” FG2 P3 243–245 |
| Disturbs loved ones’ sleep | “I can't sleep. I got to go to school [in the] morning. I wake up at six o’clock in the morning to be at school by seven. So if I'm up all night [from her scratching], it’s kind of hard to go to school and concentrate.” FG5 FM2 86–88 | |
| Daily activities | Decrease in regular activities | “There [are] a lot of things we used to do [that now] we just can’t because she is having pain and itching and she is not comfortable going out with all of the sores and plaques all over her body and bleeding all over everything; and she is not comfortable leaving the house as much anymore, so that has been a big change. [...] We used to do things like taking the kids to a park, a pool, the movies, even going grocery shopping [...] even when we are doing grocery shopping [...], we do it late at night because there are no people there. She is not comfortable being around people, and I can’t do it myself [cries].” FG4 FM2 36-39, 41–44 |
| Excessive cleaning | “You vacuum forever [laugh].” FG2 P2 198 | |
| Relationships | Intimate/sexual relationships | M: “Has [psoriasis] ever affected your sex life?” P5: “Only because it was embarrassing. You're like, ‘Honey, rub my arm or my whatever.’ I mean, it didn't bother him, but it's off-putting.” FG1 P5 610–612 |
| Isolation from others | “If I am itching and sore and embarrassed, I do not socialize with anybody, not even my daughter and my grandson. I lock myself in a room.” IT1 P 109–110 | |
| Sadness, sympathy from others | What bothers me the most—I got used to seeing plaques of his psoriasis and everything—but to see him in pain and itching so much that he will bleed, it broke my heart.” FG4 FM1 59–60 | |
| Annoyance, anger from others | “S**t gets everywhere, like armchairs. It’s worse than a dog shedding. [My wife] asks me why I itch it, but it’s because it f***ing itches. […] Why can’t you just understand? I’m sorry I’m making a mess. She asks, ‘Why don’t you go to the doctor?’ I have! Nothing works.” FG3 P5 225–228 |
FG: focus group; FM: family member; P: participant with psoriasis; IT: interview
*Study nomenclature: Interview type, person speaking, transcript lines.