# Cutaneous Psoriasis and Symptoms (Itch, Pain, and Burning Sensation): A Monocentric Retrospective Study on 299 Patients in Italy

## TL;DR

This study shows that psoriasis patients often experience symptoms like itch, pain, and burning, which significantly affect their quality of life and are not always linked to visible disease severity.

## Contribution

The study highlights the importance of assessing subjective symptoms in psoriasis, revealing their frequency and impact independent of traditional clinical severity measures.

## Key findings

- Itch was reported by 73% of patients, while burning and pain were reported by 43% and 27%, respectively.
- Patients with longer disease duration experienced more itch and burning, and those on systemic treatment reported fewer symptoms.
- Higher PASI and BSA scores correlated with greater itch intensity, but significant symptoms were also present in patients with low clinical severity.

## Abstract

Background: Psoriasis is a chronic inflammatory skin disease with a strong psychosomatic component. While clinical severity is traditionally measured using the PASI and BSA, subjective symptoms such as itch, pain, and burning sensation significantly impact patients’ quality of life and remain under-assessed. Methods: We conducted a retrospective observational study on 299 adult patients with psoriasis evaluated at a tertiary dermatology center in Italy. Data on itch, pain, and burning were collected using validated patient-reported outcome measures. Disease severity (PASI and BSA) and quality of life (DLQI) were recorded. Associations between symptoms and clinical variables were statistically analyzed. Results: Itch was the most frequent symptom, reported by 73% of patients in the previous 4 weeks. Burning and pain were reported by 43% and 27%, respectively. Longer disease duration was associated with increased itch and burning (p < 0.05). Patients receiving systemic treatment showed significantly fewer symptoms (p < 0.05). Higher PASI and BSA scores correlated with a greater itch intensity. Importantly, significant symptoms were also reported by patients with low clinical severity. Higher DLQI scores were associated with increased symptom burden and emotional distress. Conclusions: Subjective symptoms such as itch, burning, and pain are frequent, clinically relevant, and not always proportional to visible disease severity. These findings underscore the need for routine symptom assessment in psoriasis and support a patient-centered approach in both clinical practice and therapeutic strategies.