Presence of Painful Itch May Signal Skin Cancer

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Pain intensity linked to inflammation, ulceration, perineural invasion, depth of invasion.
Pain intensity linked to inflammation, ulceration, perineural invasion, depth of invasion.

The presence and intensity of pain and itch may be indicators of skin cancer, according to a study published online in JAMA Dermatology.

Gil Yosipovitch, M.D., from the Temple University School of Medicine in Philadelphia, and colleagues examined the correlation between pain and itch and histologic features of skin cancers in a prospective study. Participants included 268 patients, with 339 histopathologically confirmed cutaneous neoplasms, including basal cell carcinomas, squamous cell carcinomas, and melanomas.

The researchers found that the prevalence of itch was 36.9 percent and the prevalence of pain was 28.2 percent across all skin cancers, but these symptoms were mainly absent in melanomas.

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Significant correlations were seen for pain intensity with degree of inflammation (mild or none versus moderate or marked; P < 0.001); presence of neutrophils in inflammatory infiltrate (mainly mononuclear versus mixed or neutrophilic; P = 0.003); presence of eosinophils (present versus absent; P = 0.007); ulceration (present versus absent; P = 0.003); perineural invasion (present versus absent; P < 0.001); invasion depth (P = 0.001); and largest diameter length of skin lesion (P < 0.003).

There were significant correlations for itch intensity with degree of inflammation (mild or none versus moderate or marked; P = 0.001) and eosinophil presence (present versus absent; P = 0.02).

"This study also reports that a simple bedside assessment for the presence and intensity of pain or itch is an easily implementable tool for physicians evaluating suspicious skin lesions," the authors write.

  1. Yosipovitch, Gil, et al. "Association of Pain and Itch With Depth of Invasion and Inflammatory Cell Constitution in Skin cancer Results of a Large Clinicopathologic Study." JAMA Dermatology. doi:10.1001/jamadermatol.2014.895. July 23, 2014.

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