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Itch prevalence and severity remain stable over time in systemic sclerosis cohort studyFor people with scleroderma, how common is itch — and does it ever go away?

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Key Takeaway
Consider that itch affects about one-third of SSc patients with stable prevalence and moderate severity over time.

A multinational observational cohort study followed 2173 people with systemic sclerosis (87.3% women, mean age 54.7 years, 40.2% with diffuse cutaneous SSc) from the Scleroderma Patient-centred Intervention Network Cohort. Participants completed assessments at enrollment and at 3-month intervals, with a mean of 9.1 assessments per participant. The study examined itch probability (score >0 on a 0-10 numerical rating scale) and, when present, itch severity.

Predicted itch probability ranged between 35.0% and 36.8% across all combinations of age at disease onset and disease duration examined, with 95% confidence intervals of 31.8% to 38.5% for the lower estimate and 33.3% to 40.4% for the upper estimate. Mean itch severity among those experiencing itch was between 4.1 and 4.4 across all combinations, with 95% confidence intervals of 4.1 to 4.1 for the lower estimate and 4.3 to 4.4 for the upper estimate. Both prevalence and severity showed stable patterns rather than progressive changes over time.

Safety and tolerability data were not reported in this analysis. The study has several limitations: it is observational and therefore shows associations rather than establishing causal relationships, it does not report on the effectiveness of any management strategies for itch, and key methodological details including funding and conflicts of interest were not reported. For clinical practice, these findings suggest that itch is a common symptom in systemic sclerosis affecting approximately one-third of patients, with moderate severity when present, and that clinicians should be aware it may occur regardless of disease duration rather than being primarily associated with early or late disease stages.

If you have scleroderma, you know the relentless itch can be as draining as the pain. A new study tracking over 2,100 patients paints a clear picture: this isn't a symptom that just comes and goes. The data shows that roughly 35% to 37% of people with scleroderma are dealing with itch at any given time. And for those who have it, the severity hovers at a moderate level, around a 4 out of 10, and stays remarkably stable. It doesn't seem to get much better or worse as the disease progresses or based on when someone first got sick.

The research followed people in a large international network, checking in on their symptoms every few months. What's striking is that the itch probability and its intensity held steady regardless of how long someone had lived with scleroderma. This challenges the idea that itch is just an early-phase problem.

It's important to remember this was an observational study. It tells us itch is common and persistent, but it can't prove what causes it or whether treating the underlying disease differently would change things. The study also didn't look at what treatments people were using for itch or how well they worked. So while it firmly establishes itch as a major, ongoing issue, the search for the best ways to relieve it continues.

What this means for you:
Itch affects about 1 in 3 people with scleroderma and tends to stay at a steady, moderate level over time.

Study Details

Study typeCohort
Sample sizen = 2,173
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
Background: Itch in systemic sclerosis (SSc) is thought to be most significant in early disease, but no longitudinal studies have examined itch course. We estimated itch presence and severity from SSc disease onset, accounting for participant age and time since onset at each assessment. Methods: People with SSc from the multinational Scleroderma Patient-centred Intervention Network Cohort completed past-week itch severity assessments (0 to 10 numerical rating scale) at enrolment and longitudinally at 3-month intervals. To estimate itch probability (score > 0) and, if present, itch severity, we used two-stage mixed effects models with basis splines to address non-linearity. The primary predictor was age at each assessment, partitioned into age at non-Raynaud phenomenon symptom onset and time since onset. We estimated prevalence and severity for onset ages of 20, 30, 40, 50 and 60 years and, for each onset age, at 2 years, 3 years, 4 years, 5 years, 7 years, and 5-year intervals 10 years to 35 years post-onset. Findings: We included 2173 participants with 19 733 itch assessments (mean [standard deviation] 9.1 [6.9] assessments). 1896 of 2173 (87.3%) participants were women. Mean age at enrolment was 54.7 (SD 12.7) years. 873 (40.2%) participants had diffuse cutaneous SSc. Predicted itch probability was between 35.0% (95% CI 31.8% to 38.5%) and 36.8% (95% CI 33.3% to 40.4%) at all onset age and disease duration combinations. Mean itch severity, when present, was moderate, between 4.1 (95% CI 4.1 to 4.1) and 4.4 (95% CI 4.3 to 4.4), for all age and duration combinations. Interpretation: Itch prevalence and mean severity were stable across onset ages and over time within onset ages. Findings suggest that itch is common in SSc and not as closely related to disease duration as previously thought. Research is needed to elucidate itch pathophysiology and identify effective management strategies.
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