Cross-cultural validation of the Itch Man Scale in pediatric burn survivors in a South African setting

Introduction: Pruritus or itch is a common symptom after burn injuries. The Itch Man Scale has been recommended to assess itch severity in children. The aim of this prospective observational study was to perform a cross-cultural validation of the Itch Man Scale by comparing it with the Numeric Rating Scale (NRS) and the Toronto Pediatric Itch Scale. 

Method: At Red Cross War Memorial Children's Hospital in Cape Town, South Africa, parents of pediatric burn patients assessed their child's itch with the Itch Man Scale, NRS and Toronto Pediatric Itch Scale. Children from the age of 6 years also rated the Itch Man Scale and NRS themselves. The Spearman rank order correlation between the different scales was calculated to determine construct validity. 

Results: Over a two-month period, 255 pediatric burn survivors with a median age of 2.3 years (IQR 1.4–4.0) were included; 35 of them were aged 6–13 years. Parents’ Itch Man Scale ratings correlated significantly with parents’ NRS ratings (0.82, 95% CI 0.78–0.86) and with the Toronto Pediatric Itch Scale of the parent (0.80, 95% CI 0.75–0.84). The correlation between the older children's Itch Man Scale rating and those of their parents was 0.66 (95% CI 0.37–0.83). 

Conclusion: We concluded that the Itch Man Scale has promising validity and is a user-friendly tool to use in clinical practice to determine the itch intensity in children younger than 13 years in a South African setting.