Pain severity and use of analgesic medication in adults with atopic dermatitis: a cross-sectional study.

BACKGROUND

Adult patients with atopic dermatitis (AD) report skin pain, but the relationship with disease severity, anatomical location and use of pain medication is unclear.

OBJECTIVES

To examine pain in adults with AD.

METHODS

We performed a cross-sectional study of nationwide healthcare data and survey data from the Danish Skin Cohort. In total, 3208 randomly selected adults from the general population and 3834 adults with a dermatologist-verified diagnosis of AD present in adulthood were included. Patient-Oriented SCORing Atopic Dermatitis determined AD severity, and numerical rating scales estimated the severity of pruritus and skin pain. Complete information on the use of analgesic medication was obtained from the Danish nationwide prescription registry.

RESULTS

Respectively, 6·8%, 55·5%, 34·0% and 3·7% of the AD cohort reported that they were asymptomatic, or had mild, moderate or severe disease at the time of assessment. Skin pain was positively associated with AD severity and itch. Higher skin pain scores were observed in plantar, chest and palmar areas. Use of pain medication was not increased in patients with AD.

CONCLUSIONS

Patients with AD did not display increased use of pain medication, but few had severe disease. The close relationship observed between itch and pain highlights the potential benefits of established AD treatments to also reduce skin pain in AD. What's already known about this topic? There is increased awareness about skin pain being a significant burden of atopic dermatitis (AD). What does this study add? We found that skin pain is increased with AD severity and itch. The comparable use of pain medication in patients with AD and controls suggests that dermatological treatments reduce skin pain.