Pain Is a Common and Burdensome Symptom of Atopic Dermatitis in United States Adults.


Journal

The journal of allergy and clinical immunology. In practice
ISSN: 2213-2201
Titre abrégé: J Allergy Clin Immunol Pract
Pays: United States
ID NLM: 101597220

Informations de publication

Date de publication:
Historique:
received: 08 04 2019
revised: 25 05 2019
accepted: 29 05 2019
pubmed: 23 6 2019
medline: 9 10 2020
entrez: 23 6 2019
Statut: ppublish

Résumé

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.

Sections du résumé

BACKGROUND
Atopic dermatitis (AD) is associated with skin pain. However, little is known about the prevalence and associations of pain in AD.
OBJECTIVE
To characterize the frequency, intensity, characteristics, and associations of pain from AD.
METHODS
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).
RESULTS
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.
CONCLUSIONS
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.

Identifiants

pubmed: 31228619
pii: S2213-2198(19)30555-0
doi: 10.1016/j.jaip.2019.05.055
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2699-2706.e7

Informations de copyright

Copyright © 2019 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Auteurs

Jonathan I Silverberg (JI)

Departments of Dermatology, Preventive Medicine and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Ill. Electronic address: JonathanISilverberg@gmail.com.

Joel M Gelfand (JM)

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.

David J Margolis (DJ)

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.

Mark Boguniewicz (M)

Division of Pediatric Allergy and Clinical Immunology, Department of Pediatrics, National Jewish Health and University of Colorado School of Medicine, Denver, Colo.

Luz Fonacier (L)

Department of Medicine, NYU Winthrop Hospital, Mineola, NY.

Mitchell H Grayson (MH)

Division of Allergy and Immunology, Nationwide Children's Hospital - The Ohio State University College of Medicine, Columbus, Ohio.

Zelma C Chiesa Fuxench (ZC)

Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa.

Eric L Simpson (EL)

Department of Dermatology, Oregon Health & Science University, Portland, Ore.

Peck Y Ong (PY)

Clinical Immunology and Allergy, Children's Hospital Los Angeles, University of Southern California, Keck School of Medicine, Los Angeles, Calif.

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