Atopic Dermatitis Linked to High Disease Burden
A new study designed to explore the relationship between atopic dermatitis (AD) severity, comorbidities, and quality of life (QOL) found that AD was commonly linked to limited lifestyle (51.3%), avoidance of social interaction (39.1%), and impacted activities (43.3%).1
Researchers analyzed data from a cross-sectional, population-based study of 602 adults, sampled from the GfK Knowledge Panel. AD severity was assessed using self-reported global AD severity, Patient-Oriented Eczema Measure (POEM), Patient-Oriented Scoring AD (POSCORAD), POSCORAD-itch and sleep. QOL was assessed using the short-form (SF)-12 mental and physical health scores and Dermatology Life Quality Index (DLQI).
Adults with AD were more likely to report having fair/poor overall health (25.8% vs 15.8%), being somewhat/very dissatisfied with life (16.7% vs 11.4%), have a lower weighted mean SF-12 mental score (45.9 vs. 50.9) and physical scores (53.0 vs 53.5), and higher DLQI (4.9 vs 1.1).
AD severity was correlated to significant stepwise decreases on overall health, life satisfaction, and mental health and increases of DLQI scores. Physical health scores were only associated with moderate AD.
The most burdensome symptoms reported were itch (54%), excessive dryness or scaling (19%), and red or inflamed skin 7%). Skin pain and sleep disturbances were also mentioned.
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“Those with moderate or severe eczema were less likely to report itch or excessive dryness or scaling as their most burdensome symptoms,” said Jonathan I. Silverberg, MD, PhD, MPH, lead author of the study. “A higher proportion of that group reported blisters or bumps, sleep disturbance, pain and open sores or oozing as their most burdensome symptoms. In addition, a high percentage of all those surveyed considered themselves to only have fair (25%) or poor (15%) overall health and reported being somewhat (16%) or very (11%) dissatisfied with life compared to those who do not have eczema.”2
Researchers noted that AD was associated with worse quality of life scores compared to other chronic diseases, including heart disease, diabetes, and high blood pressure.
“These data support the heavy burden that moderate and severe AD place on patients,” the researchers concluded. “We recommend that clinicians incorporate quality of life assessments in clinical practice to determine disease-burden, identify patients requiring step-up treatment of their skin disease and potentially screen for patients with mental health disturbances.”
1. Silverberg JI, Gelfand JM, Margolis DJ, et al. Patient-burden and quality of life in atopic dermatitis in US adults: A population-based cross-sectional study [published online July 16, 2018]. Ann Allergy Asthma Immunol. doi:10.1016/j.anai.2018.07.006.
2. Study shows painful eczema symptoms negatively impact quality of life [press release]. Arlington Heights, IL: American College of Allergy, Asthma, and immunology, July 16, 2018. https://acaai.org/news/study-shows-painful-eczema-symptoms-negatively-impact-quality-life. Accessed July 16, 2018.