Elsevier

Dermatologic Clinics

Volume 35, Issue 3, July 2017, Pages 303-316
Dermatologic Clinics

Patient Burden of Atopic Dermatitis

https://doi.org/10.1016/j.det.2017.02.004Get rights and content

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Key points

  • Patient burden in atopic dermatitis (AD) is significant and is comparable to other dermatoses without systemic involvement.

  • Itch and pain are the most common symptoms in AD, and can have pronounced detrimental effects on quality of life (QoL) and sleep in patients with AD.

  • Disease impacts include work and leisure limitations, difficulties in interpersonal relationships, and time lost to management of the disease.

  • Most studies demonstrate a significant association between increasing disease

Measurement of patient burden in atopic dermatitis

Assessment of QoL is important in the management of AD as well as in clinical trials. Although QoL generally correlates with disease severity, they are not always closely related.5 This suggests that severity as assessed by clinicians does not fully capture the impact on patients. Therefore, when making therapeutic decisions, clinicians should take the QoL impact of a patient’s AD into account and not only rely on assessments of symptoms and signs. For example, a patient with mild disease based

Itch and Pain

Itch perpetuates the dermatitis cycle and is a major component of the diagnostic criteria for AD.10 In an electronic questionnaire-based study of 304 patients with AD, 91% reported daily itch and 68% experienced itch more than 4 times each day.11 Most patients who experience itch find it difficult to live with. The National Family Opinion survey in 2001 included 559 respondents with a self-reported history of AD symptoms or diagnosis.12 In this population, 63.2% of respondents rated their

Effects of treatment on quality of life in patients with atopic dermatitis

Many AD treatment studies include QoL measures, and almost all report improvement of QoL measures that parallel response to treatment.

Several large studies have evaluated the impact of topical calcineurin inhibitors on QoL. According to these studies, treatment with topical tacrolimus and pimecrolimus improves QoL in parallel with improvements in disease severity in children and adults.37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48 One of the largest of these was a postmarketing surveillance

Summary

AD creates a significant burden on patients. Knowledge of the key contributors to decreased QoL can direct clinicians to better assess burden on an individual basis. Validated tools to assess QoL can be helpful in assessing or monitoring patient burden and response to treatment, and can be incorporated relatively easily into routine clinical care, especially those that can be answered and scored quickly and simply at a patient’s appointment.8, 9 In lieu of these standardized tools, clinicians

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    Disclosure Statement: Dr A.M. Drucker is an investigator for Sanofi and Regeneron and has received honoraria from Astellas Canada.

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