Atopic Dermatitis Associated With Impaired Quality of Life, Overall Health

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Study participants had a history of skin crease involvement, asthma or hay fever, and general dry skin, as well as visible flexural eczema and/or onset at <2 years of age.
Study participants had a history of skin crease involvement, asthma or hay fever, and general dry skin, as well as visible flexural eczema and/or onset at <2 years of age.

A diagnosis of atopic dermatitis was found to be associated with impaired quality of life (QoL) with regard to both mental and physical health, as well as a lower overall health rating and life satisfaction, according to a study published in the Annals of Allergy, Asthma & Immunology.

A group of researchers sought to evaluate the patient burden of atopic dermatitis by examining the relationship between disease severity, comorbidities, and overall QoL. Participants included a sample of 2137 adults from the GfK Knowledge web panel who participated in a survey; 1278 (59.8%) participants completed the survey. A separate sample (8217) was also identified to investigate differences between different levels of disease severity; the final cohort for this sample consisted of 602 patients (53.6% women, 71.9% white).

UK Working Party criteria for a diagnosis of atopic dermatitis included having an itchy skin condition during the past 12 months and 3 or more of the following: history of skin crease involvement; personal history of asthma or hay fever; history of general dry skin during the previous year; visible flexural eczema; and/or onset at <2 years of age.

Self-assessment of AD included the question, “Would you describe your atopic dermatitis or eczema as mild, moderate, or severe?” Other patient-reported outcomes included the Patient-Oriented Scoring AD (PO-SCORAD) index [range: 0-103], numeric rating scale (NRS) itch and sleep subscores of PO-SCORAD [range: 0-10], Patient-Oriented Eczema Measure (POEM) [7 questions; range: 0-28],  the Dermatology Life Quality Index (DLQI) [10 questions; range: 0-30], and the Short-Form 12 (SF-12) [2 subscales, 12 items; range: 0-100]. All analyses were divided into 4 categories (none, clear/almost clear/mild, moderate, severe/very severe).

The overall prevalence of atopic dermatitis was 7.3%. Of those who described global atopic dermatitis severity, 289 (53.1%) reported having mild, 172 (38.8%) moderate, and 34 (8.1%) severe disease. The mean PO-SCORAD score was 27.5, POEM was 7.5, and the DLQI was 4.9. Compared with those without atopic dermatitis, a greater percentage of adults with the condition reported having fair or poor overall health (25.8% vs 15.8%), and they felt somewhat or very dissatisfied with life (16.7% vs 11.4%). Fair or poor health and feeling somewhat or very dissatisfied with life was reported by 35.0% and 31.6% of patients with severe atopic dermatitis, respectively).

Atopic dermatitis was associated with lower SF-12 mental and physical health subscores and higher DLQI scores, which indicates impaired QoL. A large proportion of adults with atopic dermatitis reported that the condition limited their lifestyle (51.3%) and affected social interactions (39.1%); these numbers were greater in those with moderate and severe atopic dermatitis. The most bothersome symptoms reported were itch (54.4%), excessive dryness or scaling (19.6%), and red or inflamed skin (7.2%). A larger proportion of patients with moderate and severe atopic dermatitis reported blisters or bumps, red or inflamed skin, sleep disturbance, pain, and open sores or oozing.

“Using a US population-based sample, we found that adults with [atopic dermatitis] had lower overall health rating and life satisfaction, significantly lower SF-12 mental health subscores, and higher DLQI scores; all of these indicate significant QOL impairment,” the authors concluded.

Disclosures: Please refer to full article for a listing of author disclosures.  This study was sponsored by Sanofi Genzyme and Regeneron.

Reference

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 6, 2018].  Ann Allergy Asthma Immunol. doi: 10.1016/j.anai.2018.07.006

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