Ortiz de Frutos F J, Torrelo A, de Lucas R, González M A, Alomar A, Vera Á, Ros S, Mora A M, Cuervo J
Hospital Universitario 12 de Octubre, Madrid, España.
Hospital Infantil Universitario Niño Jesús, Madrid, España.
Actas Dermosifiliogr. 2014 Jun;105(5):487-96. doi: 10.1016/j.ad.2014.01.004. Epub 2014 Mar 13.
To analyze the triggers of atopic dermatitis (AD), adherence to medical recommendations, disease control, and health-related quality of life (HRQOL) from the patient's perspective.
This was a multicenter, cross-sectional, epidemiological study with the participation of adults (age >16 years; n=125) and children (age, 2-15 years, n=116). Patients had a history of at least 12 months of moderate to severe AD with a moderate to severe flare (Investigator Global Assessment score>2) at the time of recruitment. The Mann-Whitney U test was used to evaluate relationships between disease severity, determined according to the Scoring in Atopic Dermatitis index, and triggers reported by patients, adherence to recommendations and pharmacological therapy, HRQOL, and patient-perceived control.
The most common triggers were cosmetic products, clothing, mites, detergents/soaps, and changes in temperature. In 47.2% of adults and 39.7% of children, pharmacological therapy was not initiated at flare onset. Adherence was highest to pharmacological therapy, skin moisturizing, and medical care recommendations. Disease control was considered insufficient by 41.6% of adults and 27. 6% of pediatric patients and, in adults, this was associated with the severity of AD (P=.014).
The therapeutic control of AD is susceptible to improvement, especially in adults. Although patients state that they follow medical recommendations, a significant percentage of patients do not apply recommended treatments correctly. Better education about the disease and its management would appear to be necessary to improve disease control and HRQOL.
从患者角度分析特应性皮炎（AD）的触发因素、对医疗建议的依从性、疾病控制情况以及健康相关生活质量（HRQOL）。
这是一项多中心、横断面的流行病学研究，有成人（年龄>16岁；n = 125）和儿童（年龄2 - 15岁，n = 116）参与。患者在招募时患有至少12个月的中度至重度AD且伴有中度至重度发作（研究者整体评估评分>2）。采用曼-惠特尼U检验来评估根据特应性皮炎指数评分确定的疾病严重程度与患者报告的触发因素、对建议和药物治疗的依从性、HRQOL以及患者感知的控制之间的关系。
最常见的触发因素是化妆品、衣物、螨虫、洗涤剂/肥皂以及温度变化。在47.2%的成人和39.7%的儿童中，发作时未开始药物治疗。对药物治疗、皮肤保湿和医疗护理建议的依从性最高。41.6%的成人和27.6%的儿科患者认为疾病控制不足，在成人中，这与AD的严重程度相关（P = 0.014）。
AD的治疗控制仍有改善空间，尤其是在成人中。尽管患者表示他们遵循医疗建议，但仍有相当比例的患者未正确应用推荐的治疗方法。为改善疾病控制和HRQOL，似乎有必要对该疾病及其管理进行更好的教育。
