Thyssen J P, Halling-Sønderby A-S, Wu J J, Egeberg A
Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, Hellerup, Denmark.
Br J Dermatol. 2020 Jun;182(6):1430-1436. doi: 10.1111/bjd.18557. Epub 2019 Nov 27.
Adult patients with atopic dermatitis (AD) report skin pain, but the relationship with disease severity, anatomical location and use of pain medication is unclear.
To examine pain in adults with AD.
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.
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.
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.
成年特应性皮炎（AD）患者报告有皮肤疼痛，但与疾病严重程度、解剖部位及止痛药物使用之间的关系尚不清楚。
研究成年AD患者的疼痛情况。
我们对丹麦皮肤队列的全国医疗数据和调查数据进行了横断面研究。总共纳入了3208名从普通人群中随机选取的成年人以及3834名成年期经皮肤科医生确诊为AD的成年人。以患者为导向的特应性皮炎评分（Patient-Oriented SCORing Atopic Dermatitis）确定AD严重程度，数字评定量表评估瘙痒和皮肤疼痛的严重程度。从丹麦全国处方登记处获取有关止痛药物使用的完整信息。
AD队列中分别有6.8%、55.5%、34.0%和3.7%的患者报告在评估时无症状，或患有轻度、中度或重度疾病。皮肤疼痛与AD严重程度和瘙痒呈正相关。在足底、胸部和手掌部位观察到更高的皮肤疼痛评分。AD患者的止痛药物使用并未增加。
AD患者并未表现出止痛药物使用增加，但很少有严重疾病患者。观察到的瘙痒与疼痛之间的密切关系凸显了现有AD治疗方法在减轻AD皮肤疼痛方面的潜在益处。关于该主题已知的信息有哪些？人们越来越意识到皮肤疼痛是特应性皮炎（AD）的一项重大负担。本研究增加了什么内容？我们发现皮肤疼痛随AD严重程度和瘙痒而增加。AD患者与对照组止痛药物使用情况相当，这表明皮肤科治疗可减轻皮肤疼痛。
