Greater atopic dermatitis severity linked to worse quality of life in pediatric patients

Key takeaways:

• Patients with moderate or severe disease reported more itch and pain than those with mild disease.
• Those with severe disease experienced 5 days a week of sleep disturbances vs. 1 to 2 days among mild patients.

Pediatric patients with severe atopic dermatitis experienced higher rates of itch, pain, sleep disturbances and missed school days compared with those with mild disease, according to a study.

“While the burden of AD in pediatric populations has been suggested to be multidimensional, including effects on sleep and [health-related quality of life], there remains a gap in the broader quantitative characterization of the 10 disease burden by AD severity across age groups (infants, children and adolescents),” Stephan Weidinger, MD, PhD, of the department of dermatology and department of allergology and venereology at the University Hospital Schleswig-Holstein in Germany, and colleagues wrote.

To better characterize the burden of different AD severities among pediatric patients, the authors conducted an international web-based survey. The study’s findings included self- or parent-reported responses from children aged 6 months to less than 6 years (n = 1,489), children aged 6 years to less than 12 years (n = 2,898) and adolescents aged 12 years to less than 18 years (n = 3,078) from five geographic regions. Patient-Oriented Eczema Measure and Patient Global Assessment were used to assess AD severity.

While pediatric patients with mild AD experienced significant itch (2-3.7) and pain (1.7-3.6), based on mean numerical rating scale scores, those with moderate or severe AD reported significantly higher rates of itch (4.3-6.5 and 6.2-7.5, respectively) and skin pain (3.5-6.4 and 4.9-7.3).

Those with higher AD severity also reported higher rates of sleep problems. In those with severe AD, more than 70% experienced sleep disturbances at least 5 days a week, although more than 90% of patients with mild AD still reported “no days” or 1 to 2 days of weekly sleep disturbances.

Patients with severe AD also reported lower health-related quality of life scores and missed more days of school compared with those with mild AD.

Across all severity groups, 92.5% of patients reported at least one atopic comorbidity. The number of study participants with one or more comorbidity appeared to increase with both AD severity and age, according to the authors.

“In addition to emphasizing the need for appropriate treatment in the pediatric population regardless of AD severity, these results highlight the importance of incorporating a broader assessment that goes beyond clinical signs and symptoms by taking into account the impact of AD, and its management, on the function and daily life of children afflicted with this disease,” the authors concluded.