A sub-analysis of a multicountry study reports that, in addition to physical symptoms like pain and itching, individuals with AD also suffer from a decreased quality of life, which is evident through disrupted sleep, decreased ability to work, financial burdens, heightened anxiety/depression, and limited capacity to perform everyday tasks.
Atopic dermatitis (AD) is a persistent, inflammatory skin condition linked to substantial disease impact. The primary burden of AD stems from its signs and symptoms, resulting in significant sleep deprivation and subsequently affecting the individual’s quality of life. This can lead to the onset of mental health issues such as anxiety and depression, as well as difficulties at work or school.
This study, published in the journal Dermatology Practical & Conceptual, is a sub-analysis of the global cross-sectional MEASURE-AD study.
Baseline Characteristics
Out of a total of 118 patients, 63 (53.4%) were males. The mean age was 37.71±5.4 years. The mean age at onset was 13.3±17.9 years, and 44.1% (N = 52) of patients had a family history of AD. The majority of the patients reported additional health conditions related to allergies, with the most common being allergic rhinitis (48.3%) and allergic asthma (33.9%). Non-atopic comorbidities were present in around one-third of patients (33.9%; N = 40), with the most common being hypertension (12.5%; N = 15), anxiety (11.9%; N = 14), depression, and diabetes (both 4.2%; N = 5).
Most Patients Had Moderate-To-Severe AD by EASI and BSA Scores
The mean Eczema Area and Severity Index (EASI) score was 11.2±11.5. Moderate-to-severe AD was present in 57.6% of patients, according to Chopra, and 53.4% of patients, according to Leshem. The mean body surface area affected by eczema was 18.7±20.3%. The body surface area (BSA) criteria categorized 40.7% of patients as having moderate-to-severe AD.
Eczema Affects Sleep Quality and Daily Activities of Patients
Patients, on average, had 2.7±2.5 days of disrupted sleep in the past week, and 58.5% said that it affected their daily activities. Additionally, 33.1% of patients had trouble falling asleep because of itching, and 41.5% suffered disrupted sleep because of eczema-related itchiness. The mean score for skin pain varied between 32.4 and 47.8, with more than half of patients reporting a pain level of 4 or above. The mean Dermatology Life Quality Index (DLQI) score was 8.7±7.3 suggesting a modest effect of AD on quality of life.
Anxiety and Depression Are Prevalent in AD Patients
The mean score on the anxiety portion of the Hospital Anxiety and Depression Scale (HADS) was 6.3±4.1, and 35.6% of patients scored 8 or above. The average HADS depression score was 5.1±4, and 31.4% scored ≥8. Around 66% of patients showed no pathological symptoms of anxiety or depression, while about 10% reported clinically significant levels of anxiety or depression.
AD Affects Work Productivity and Expenses of Patients
The mean presenteeism for the proportion of currently employed patients (N = 62; 52.5%) was 32.8±29.6%, the mean absenteeism was 7.1±18.1%, and the mean overall work productivity impairment was 36.1 ± 30.9%. A mean of 1.75±6 hours were missed from work over the previous week. The mean work activity impairment on daily life was 38.6 ± 31.7%.
The monthly healthcare expenses and everyday requirements costs associated with AD were 90.1±93.9 EUR and 56.7±63.1 EUR, respectively. The overall monthly expenses were 148.6±134.7 EUR, which was equivalent to 0.72±0.9% of the annual household income. (At the time of publication, 1 USD is equivalent to 0.92 EUR.)
Source:
Argenziano, G., Mercuri, S. R., Savoia, P., Amerio, P., Fortina, A. B., Bongiorno, M. R., De Felici Del Giudice, M. B., Parodi, A., Pimpinelli, N., Stingeni, L., Ortoncelli, M., Stinco, G., Gualberti, G., Levi, A., Scuderi, V., Bianchi, L., & Malara, G. (2024). Burden of Disease in Real-Life setting of patients with Atopic dermatitis: Italian data from the MEASURE-AD study. Dermatology Practical & Conceptual, e2024079. https://doi.org/10.5826/dpc.1401a79
