The mean levels of anxiety (5.5 Thanks to common and worldwide usage of the HADS questionnaire it is quite easy to conduct an assessment comparing not only myeloproliferative disorders, but also any other itchy condition (including dermatoses) with PV-associated AP. This study highlights the serious impact of AP on a wide spectrum of psychosocial aspects, indicating pruritus intensity, its extent and duration as the most important factors negatively influencing patients’ well-being. Moreover, in concordance to our results, the data found for dermatological patients experiencing chronic itching also revealed that the group with pruritus had more symptoms associated with anxiety (27). Moreover, the main issue regarding treatment of AP is not only ineffectiveness of current therapies, but also the lack of ordering of any anti-pruritic treatment for patients with AP. Of note, a negative correlation between duration of AP and EQ-5D-VAS (R = –0.45, Sleep disturbances, described as waking during the night due to itching, were observed among 16.7% of patients with AP. PV-associated pruritus puts an additional burden on patients with PV.Despite the onset of AP preceding the diagnosis of PV in approximately half of studied cases, only a small percentage of the physicians consider a haematological condition as an underlying cause.
VAS cut-off points are as follows: mild pruritus (0–< 3 points), moderate pruritus (≥ 3–7 points), severe pruritus (≥ 7–9 points), and very severe pruritus (≥ 9 points) (10).Participants assessed their itch intensity on the VRS by selecting one of the following options: “none”, “mild”, “moderate”, “severe”, or “very severe”.The 4-item Itch Questionnaire was used to estimate the extent (1–3 points), intensity (1–5 points), frequency (1–5 points) and sleep disturbances (0–6 points) caused by AP during the 3 days prior to the examination. The aim of this study was to broaden our understanding of this detrimental and life-inhibiting condition.AP was first reported as an important clinical feature of PV in 1985 (4), although the disease was described earlier, in 1970, by Shelley (5), who distinguished it from aquagenic urticaria.

Aquagenic pruritus Causes Mostly the underlying causes of aquagenic pruritus are unknown. The presence of AP was not determined with reference to control of PV.The range of duration of AP was 0–44 years (mean 6.6 According to VAS, the maximum intensity of AP during last 3 days was assessed as 5.2 With reference to HADS, the prevalence of depression and anxiety disorders among AP patients was estimated as 23.8% and 9.5%, respectively. AP places an additional burden on affected patients, also impairing their QoL. Among participants receiving 5-HU, a higher intensity of pruritus according to VAS and VRS was revealed (AP, as a common feature of PV, has a significant influence on patients’ quality of life and can lead to the development of hydrophobia (17). Some of the authors (28) implied that dissociative states could be a functional way of coping with chronic pruritus, as it may be a way to withdraw from the unpleasant experience of pruritus.Such consequences of the influence of AP on QoL were also demonstrated by Siegel et al. Moreover, the lack of insight into the mechanism of cutaneous induction of PV-associated AP makes treatment of this condition constantly challenging. Of course, it is also true that AP may also occur simultaneously with, or may follow the diagnosis of, PV (24).In concordance with the study by Siegel et al. Although the results were promising, the tested groups did not provide a sufficient demographic (from 2 to 22 patients). The lack of insight into the pathogenesis of AP is arguably the main reason for inadequacy in earlier therapy. psoriasis (29), hidradenitis suppurativa (Hurley I and II) (30), bronchial asthma or chronic obstructive pulmonary disease (COPD) (31), cerebral strokes (32) or blood circulation failure qualifying for heart transplantation and heart infarcts (33, 34). All rights reserved. Patients presenting other types of itching (4/102; 3.9%) were excluded. Regardless of the method chosen, the limitation of our cross-sectional study was the analysis concerning only one clinical centre with no insight into clinical course of PV, which means that the extrapolation of results to patients of other regions should be conducted with some caution. This phenomenon is, in some way, clarified by the research performed by Gangat et al. WHAT ARE THE SYMPTOMS? AP requiring scratching was found in 42.8% of individuals and appeared mostly as short itch episodes with a duration of 1–10 min (61.9%).Sleep disturbances, described as “waking during the night sleep due to itching”, were observed in 16.7% of patients with AP.No dependences were found between methods of evaluation of AP intensity and sex, body mass index (BMI) or time of diagnosis of AP (before or after PV).