Dermatitis treatment should address physical, psychosocial signs

Atopic dermatitis often causes psychosocial burdens that need to be addressed and managed with effective treatments, according to a literature review.

“Atopic dermatitis (AD), also known as eczema, is a chronic inflammatory relapsing skin disorder that is characterized by pruritus and recurrent eczematous lesions and is a disease that is prevalent in both children and adults,” Hira Ghani, BA, of the New York Institute of Technology College of Osteopathic Medicine, and colleagues wrote. “AD is associated with increased risk of psychosocial stress and development of mental health disorders.”

The researchers conducted a literature review exploring the impact AD has on psychosocial factors and how different treatments can be beneficial for both the physical and psychosocial impacts of the disease.

Children with AD, as well as their parents and caregivers, had a substantial impact on quality of life due to the children having difficulty sleeping, nightmares and poor sleep quality.

The researchers found many young people with AD often have learning disabilities, with the odds directly proportional to the severity of AD.

In addition, AD patients were less likely to attain lower secondary and upper secondary education, however higher education rates matched controls.

“Therefore, sleep disturbances associated with AD may negatively impact learning and acquisition of education in affected children and adolescents,” the authors wrote.

Pruritus associated with AD also caused adults to have poorer sleep quality and negatively affected mood and daytime activities.

Lower self-esteem, psychological distress, self-consciousness, anxiety and depression are all more common in AD sufferers, the study found.

AD treatments generally focus on reducing itch and decreasing disease severity and can include topical corticosteroids, topical calcineurin inhibitors, phototherapy and systemic immunomodulators.

The study’s authors suggested psychosocial evaluations for AD patients and treatment options that take these effects into consideration.

“The treatment of emotional and psychosocial factors linked with moderate to severe AD remains challenging, and there is a need for well-tolerated therapeutic approaches that take the psychosocial burden of the disease into account,” they wrote.