Reed Brian, Blaiss Michael S
Allergy Asthma Proc. 2018 Nov 1;39(6):406-410. doi: 10.2500/aap.2018.39.4175.
Atopic dermatitis (AD) is a dermatologic condition that affects a large percentage of children and adults in the United States. The disease process is not fully understood, and, currently, there is no cure, so today's treatment methodologies focus on the rash and the symptoms, , pruritus. Even though there is no mortality with this condition, there is significant morbidity and burden. This review concentrated on several areas in which AD influences quality of life. The areas include sleep, interference with daily activities (e.g., school and/or work), psychological stressors, and the impact on parents and caregivers. The direct and indirect costs of AD are also examined. A medical literature search was conducted that focused on quality of life (QOL), health-related quality of life, and costs in patients with AD. AD caused poor QOL as assessed in both generic and specific QOL questionnaires. Skin pain was frequently experienced in this condition, which worsens QOL. A significant effect on sleep was found in multiple studies. A large amount of school and/or work absenteeism and psychological stressors was seen in patients with AD. Multiple burdens of the caregivers and parents of patients with AD were documented. Medical costs were also significantly higher compared with patients without AD. The impact of AD is likely more significant than previously acknowledged. AD results in significant morbidity as seen through generic and specific QOL questionnaires, sleep studies, and other questionnaires that measure psychological effects. Physicians should consider evaluating patients with AD beyond their rash and symptoms to achieve the best care possible.
特应性皮炎(AD)是一种皮肤病,在美国影响着很大比例的儿童和成人。该病的发病过程尚未完全明了,目前也无法治愈,因此当今的治疗方法主要针对皮疹和症状,即瘙痒。尽管这种疾病不会导致死亡,但却会造成严重的发病情况和负担。本综述聚焦于AD影响生活质量的几个方面。这些方面包括睡眠、对日常活动(如上学和/或工作)的干扰、心理压力源以及对父母和照料者的影响。同时还研究了AD的直接和间接成本。我们进行了一项医学文献检索,重点关注AD患者的生活质量(QOL)、健康相关生活质量和成本。在通用和特定的QOL问卷评估中,AD均导致生活质量较差。在这种疾病中经常会出现皮肤疼痛,这会使生活质量恶化。多项研究发现AD对睡眠有显著影响。AD患者存在大量的缺课和/或旷工情况以及心理压力源。记录了AD患者的照料者和父母所承担的多重负担。与无AD的患者相比,医疗费用也显著更高。AD的影响可能比之前认为的更为显著。通过通用和特定的QOL问卷、睡眠研究以及其他衡量心理影响的问卷可以看出,AD会导致严重的发病情况。医生在治疗AD患者时,应考虑对患者进行皮疹和症状之外的评估,以尽可能提供最佳治疗。