Impact of Atopic Dermatitis Treatment on Child/Parent Sleep, Daytime Functioning, and Quality of Life.
Impact of Atopic Dermatitis Treatment on Child/Parent Sleep, Daytime Functioning, and Quality of Life. Ann Allergy Asthma Immunol. 2020 Jan 07;: Authors: Meltzer LJ, Flewelling KD, Jump S, Gyorkos E, White M, Hauk PJ PMID: 31923547 [PubMed - as supplied by publisher]
Atopic dermatitis (AD) impacts up to 20% of children worldwide (1;2). Children with AD experience physical discomfort, poorer quality of life (3-5), increased behavior problems (6;7), higher frequency of attention-deficit/hyperactivity disorder (ADHD) (8-11) and higher healthcare utilization (12). Parents of children with AD report decreased quality of life (13-16), negative impact on the family (14;17), increased depression and anxiety (16), and increased work absenteeism (18;19).
Recent studies have highlighted the multidimensional effect of atopic dermatitis (AD) and urticaria. Patient burden for these conditions is largely driven by the intense itching, sleep disturbance, comorbidities, and mental health illness associated with these diseases.1-3 Immunologic, microbial, and epithelial interactions have been reported to play an important role in AD.4,5 Novel therapies and management approaches are targeting the mechanisms underlying AD and urticaria.6,7 The current issue of the Annals contains 3 outstanding reviews that update readers on the pathophysiology and evolving treatments for AD and chronic urticaria.
Abstract BACKGROUND: The optimal approaches for monitoring sleep disturbances in adults with atopic dermatitis (AD) is not established. Multiple patient-reported outcome measures for AD and itch have sleep-related items. These items have not been validated previously. OBJECTIVE: Assess the measurement properties of sleep-related items from the Patient- Oriented Eczema Measure (POEM), SCORing AD (SCORAD), 5-dimensions of itch (5D) and ItchyQOL in adults with AD. METHODS: We performed a prospective dermatology practice-based study using questionnaires and evaluation by a dermatologist (n=115). RESULTS...
The optimal approaches for monitoring sleep disturbances in adults with atopic dermatitis (AD) is not established. Multiple patient-reported outcome measures for AD and itch have sleep-related items. These items have not been validated previously.
The immediate priority for clinicians managing patients with atopic dermatitis (AD) is treating the disease, particularly the constant itch and sleep disturbance, with its consequential disruption of both home and work life and association with low mood, poorer concentration, and productivity. However, long-term sequelae are important to consider and include those directly related to the atopic march (asthma, allergic rhinoconjunctivitis, and food allergies), the consequences of having a chronic disease, and potential side effects of therapy, particularly topical corticosteroids.
Children with asthma are at risk for poorer sleep outcomes. Urban minority children are disproportionately burdened by poor sleep due to sociocontextual stressors and challenges with asthma regimens. Atopic dermatitis (AD) is highly co-morbid in children with asthma and can further increase risk for poor sleep. Our study goal was to examine the sleep outcomes in urban children with asthma and determine whether AD increased risk for poorer sleep utilizing a group of urban healthy children as controls.
Discussion Atopic dermatitis (AD) has a prevalence of 3-5% in the overall U.S. population but is increasing with an estimated 10-15% lifetime risk in childhood. It is even more common in children of color with a prevalence in African-American/black children of 17% and Hispanic children of 14%. Health care utilization data also appears to support more severe disease in children of color also. Atopic dermatitis or eczema is a common dermatological skin problem which characteristically is a pruritic, papular eruption with erythema. Like most papulosquamous eruptions it often occurs in intertrigenous areas in people with alle...
Sean P. Saunders1, Erica G. M. Ma1,2, Carlos J. Aranda1 and Maria A. Curotto de Lafaille1,3* 1Division of Pulmonary, Critical Care and Sleep Medicine, Laboratory of Allergy and Inflammation, Department of Medicine, New York University, New York, NY, United States 2Sackler Institute of Graduate Biomedical Sciences, New York University, New York, NY, United States 3Department of Cell Biology, New York University School of Medicine, New York, NY, United States The long-term effectiveness of antibody responses relies on the development of humoral immune memory. Humoral immunity is maintained by long-lived plasma ce...
Itch, a sensation that leads to a desire to scratch, becomes chronic when it persists for more than 6 weeks.1 Chronic itch can be debilitating and lead to a significantly reduced quality of life. It affects sleep, mood, and can cause symptoms of anxiety and depression.2 Pruritus may be perpetuated by inflammatory conditions, as seen in atopic dermatitis and psoriasis. However, chronic pruritus may not always have an inflammatory component, and therefore requires treatments that do not work on the immune system, but instead target the nerves.
Atopic Dermatitis is a complex pruritic inflammatory skin disease that is associated with significant impairment of quality of life and high socio-economic burden.1,2 Recent studies reinforce the challenges of managing patients with severe AD as they often suffer from uncontrollable scratching, sleep disturbance, depression and systemic comorbidities.3,4 It is often associated with the atopic march5 and can be complicated by serious infection.6