Departments of Dermatology, Preventive Medicine and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Ill.
Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa; Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa.
J Allergy Clin Immunol Pract. 2019 Nov-Dec;7(8):2699-2706.e7. doi: 10.1016/j.jaip.2019.05.055. Epub 2019 Jun 20.
Atopic dermatitis (AD) is associated with skin pain. However, little is known about the prevalence and associations of pain in AD.
To characterize the frequency, intensity, characteristics, and associations of pain from AD.
A cross-sectional, US population internet survey-based study of 602 adults with AD from the AD in America Study was performed (modified UK Working Party Criteria).
Overall, 365 (61%) reported pain from AD, with 199 (33%) experiencing pain at least once per week and 30 (5%) with pain daily. Among those with AD pain, 22% reported worst pain intensity ≥7. The frequency and intensity of AD pain were associated with Patient-Oriented Scoring Atopic Dermatitis (PO-SCORAD), PO-SCORAD itch and sleep, and Patient-Oriented Eczema Measure (P ≤ .004 for all). Among those experiencing AD pain, 179 (48%) reported pain occurring only after frequent scratching, 156 (42%) reported intermittent pain, and 27 (11%) reported constant pain throughout the day. AD pain was most commonly associated with open areas caused by scratching (27%) and fissures in the skin (27%), followed by inflamed red skin (25%), with only a minority reporting pain mostly caused by burning from creams or ointments (10%). Mild AD was associated with more pain from scratching, whereas severe AD was associated with more constant pain and pain from inflamed skin.
Pain is a distinct symptom in AD, with heterogeneous frequency, characteristics, intensity, and quality of life impact. Pain was related to scratching, fissures, and/or inflamed red skin, and least from burning from topical medications. Skin pain should be assessed in patients with AD and monitoring treatment response.
特应性皮炎（AD）与皮肤疼痛有关。然而，对于 AD 患者疼痛的患病率和相关性知之甚少。
描述 AD 相关疼痛的频率、强度、特征和相关性。
采用横断面、基于美国互联网的 AD 人群调查研究，共纳入 602 例 AD 患者（改良英国工作组标准）。
总体而言，365 例（61%）报告存在 AD 相关疼痛，其中 199 例（33%）每周至少发生 1 次疼痛，30 例（5%）每天均有疼痛。在存在 AD 相关疼痛的患者中，22%报告的最痛强度≥7。AD 相关疼痛的频率和强度与患者导向特应性皮炎评分（PO-SCORAD）、PO-SCORAD 瘙痒和睡眠，以及患者导向湿疹测量（P≤0.004）均相关。在经历 AD 相关疼痛的患者中，179 例（48%）报告疼痛仅在频繁搔抓后发生，156 例（42%）报告间歇性疼痛，27 例（11%）报告全天持续疼痛。AD 相关疼痛最常与搔抓引起的开放性区域（27%）和皮肤皲裂（27%）相关，其次是炎症性红色皮肤（25%），只有少数患者报告疼痛主要由乳膏或软膏引起（10%）。轻度 AD 与搔抓引起的疼痛更多相关，而重度 AD 与更持续的疼痛和炎症性皮肤疼痛相关。
疼痛是 AD 的一个明显症状，其具有不同的频率、特征、强度和生活质量影响。疼痛与搔抓、皲裂和/或炎症性红色皮肤相关，与局部药物引起的烧灼感相关度最低。AD 患者应进行皮肤疼痛评估，并监测治疗反应。
