Boccardi Daniela, D'Auria Enza, Turati Federica, DI Vito Michele, Sortino Sabrina, Riva Enrica, Cerri Amilcare
Unit of Pediatric Dermatology, Dermatologic Clinic, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy -
Department of Pediatrics, San Paolo Hospital, University of Milan, Milan, Italy.
Minerva Pediatr. 2017 Oct;69(5):373-380. doi: 10.23736/S0026-4946.16.04294-8. Epub 2015 Jul 22.
Atopic dermatitis (AD) can significantly compromise the quality of life (QoL). The aim of our investigation was to evaluate whether QoL correlates with AD severity, evaluated through the physician and the patient perspective, in a sample of Italian children.
Forty children with AD were evaluated. Disease severity was assessed by the physician and the patients (or their parents) using the SCORAD and the patient-oriented SCORAD (PO-SCORAD) tools, respectively. Patients or their parents completed specific QoL questionnaires (IDQOL/CDLQI). Spearman's correlation coefficient and non-parametric analysis of covariance were used to analyze the data.
SCORAD e PO-SCORAD were moderately but significantly correlated (ρ Spearman=0.55, P<0.01). QoL scores ranged from 1 to 23, with a median score of 4.0 (higher scores represent more impaired QoL). After adjustment for age and sex, children with SCORAD>40 had significantly higher QoL scores (more impaired QoL) than those with SCORAD≤40 (median QoL of 5 and 4, respectively, P=0.048). Even higher differences emerged when AD severity was self-assessed (median QoL of 6 and 3.5 for children with PO-SCORAD>40 and PO-SCORAD≤40, respectively, P=0.01). AD children with concomitant food allergy had a significantly more impaired QoL than those with AD only (P=0.040). No significant difference in QoL was observed according to sex or age.
In our sample of AD children, QoL appeared slightly-moderately altered, and increasing disease severity was associated with greater impairment in QoL. SCORAD and PO-SCORAD were fairly correlated and the association of QoL was somewhat stronger with the PO-SCORAD than the SCORAD Index. This supports the usefulness of PO-SCORAD for the self-assessment of AD in children, and suggests the importance to integrate physician and patient perspectives in the management of AD.
特应性皮炎（AD）会严重影响生活质量（QoL）。我们研究的目的是评估在一组意大利儿童样本中，从医生和患者角度评估的生活质量是否与AD严重程度相关。
对40名AD儿童进行了评估。分别由医生和患者（或其父母）使用SCORAD和以患者为导向的SCORAD（PO-SCORAD）工具评估疾病严重程度。患者或其父母完成了特定的生活质量问卷（IDQOL/CDLQI）。采用Spearman相关系数和非参数协方差分析对数据进行分析。
SCORAD与PO-SCORAD呈中度但显著相关（Spearman ρ=0.55，P<0.01）。生活质量得分范围为1至23，中位数为4.0（得分越高表示生活质量受损越严重）。在对年龄和性别进行调整后，SCORAD>40的儿童的生活质量得分（生活质量受损更严重）显著高于SCORAD≤40的儿童（生活质量中位数分别为5和4，P=0.048）。当对AD严重程度进行自我评估时，差异更为明显（PO-SCORAD>40和PO-SCORAD≤40的儿童的生活质量中位数分别为6和3.5，P=0.01）。伴有食物过敏的AD儿童的生活质量受损程度明显高于仅患有AD的儿童（P=0.040）。未观察到生活质量在性别或年龄方面的显著差异。
在我们的AD儿童样本中，生活质量似乎有轻度至中度改变，疾病严重程度增加与生活质量受损程度加重相关。SCORAD与PO-SCORAD有较好的相关性，生活质量与PO-SCORAD的关联比与SCORAD指数的关联稍强。这支持了PO-SCORAD在儿童AD自我评估中的有用性，并表明在AD管理中整合医生和患者观点的重要性。
