Gender differences in adult atopic dermatitis and clinical implication: Results from a nationwide multicentre study.
Journal
Journal of the European Academy of Dermatology and Venereology : JEADV
ISSN: 1468-3083
Titre abrégé: J Eur Acad Dermatol Venereol
Pays: England
ID NLM: 9216037
Informations de publication
Date de publication:
19 Oct 2023
19 Oct 2023
Historique:
received:
23
07
2023
accepted:
06
10
2023
pubmed:
20
10
2023
medline:
20
10
2023
entrez:
19
10
2023
Statut:
aheadofprint
Résumé
Atopic dermatitis (AD) is a common inflammatory skin disease that affects both children and adults. However, limited research has been conducted on gender differences in AD. This study aimed to assess gender differences in adult AD patients, focusing on demographic and clinical features, comorbidities and treatment approaches. In this multicentre, observational, cross-sectional study, we enrolled 686 adult patients with AD (357 males and 329 females). For each patient, we collected demographic data (age and sex), anthropometric measurements (weight, height, hip circumference, waist circumference and waist-to-hip ratio), clinical information (onset age, disease duration, severity, itching intensity, impact on quality of life) and noted comorbidities (metabolic, atopic and other). We recorded past and current topical and systemic treatments. We analysed all collected data using statistical techniques appropriate for both quantitative and qualitative variables. Multiple correspondence analysis (MCA) was employed to evaluate the relationships among all clinical characteristics of the patients. We found no differences in age at onset, disease duration, severity and quality of life impact between males and females. Males exhibited higher rates of hypertriglyceridaemia and hypertension. No significant gender differences were observed in atopic or other comorbidities. Treatment approaches were overlapping, except for greater methotrexate use in males. MCA revealed distinct patterns based on gender, disease severity, age of onset, treatment and quality of life. Adult males with AD had severe disease, extensive treatments and poorer quality of life, while adult females had milder disease, fewer treatments and moderate quality of life impact. Our study reveals that gender differences in adult AD patients are largely due to inherent population variations rather than disease-related disparities. However, it highlights potential undertreatment of females with moderate AD and quality of life impact, emphasizing the need for equitable AD treatment. JAK inhibitors may offer a solution for gender-based therapeutic parity.
Sections du résumé
BACKGROUND
BACKGROUND
Atopic dermatitis (AD) is a common inflammatory skin disease that affects both children and adults. However, limited research has been conducted on gender differences in AD.
OBJECTIVES
OBJECTIVE
This study aimed to assess gender differences in adult AD patients, focusing on demographic and clinical features, comorbidities and treatment approaches.
METHODS
METHODS
In this multicentre, observational, cross-sectional study, we enrolled 686 adult patients with AD (357 males and 329 females). For each patient, we collected demographic data (age and sex), anthropometric measurements (weight, height, hip circumference, waist circumference and waist-to-hip ratio), clinical information (onset age, disease duration, severity, itching intensity, impact on quality of life) and noted comorbidities (metabolic, atopic and other). We recorded past and current topical and systemic treatments. We analysed all collected data using statistical techniques appropriate for both quantitative and qualitative variables. Multiple correspondence analysis (MCA) was employed to evaluate the relationships among all clinical characteristics of the patients.
RESULTS
RESULTS
We found no differences in age at onset, disease duration, severity and quality of life impact between males and females. Males exhibited higher rates of hypertriglyceridaemia and hypertension. No significant gender differences were observed in atopic or other comorbidities. Treatment approaches were overlapping, except for greater methotrexate use in males. MCA revealed distinct patterns based on gender, disease severity, age of onset, treatment and quality of life. Adult males with AD had severe disease, extensive treatments and poorer quality of life, while adult females had milder disease, fewer treatments and moderate quality of life impact.
CONCLUSIONS
CONCLUSIONS
Our study reveals that gender differences in adult AD patients are largely due to inherent population variations rather than disease-related disparities. However, it highlights potential undertreatment of females with moderate AD and quality of life impact, emphasizing the need for equitable AD treatment. JAK inhibitors may offer a solution for gender-based therapeutic parity.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Investigateurs
P Romita
(P)
M L Musumeci
(ML)
V Piras
(V)
A Borghi
(A)
C Loi
(C)
N Gori
(N)
F Prignano
(F)
R Gallo
(R)
M Esposito
(M)
A Campitello
(A)
L Bolzano
(L)
S Tavecchio
(S)
G Calabrese
(G)
L Di Costanzo
(L)
K Hansel
(K)
N Skroza
(N)
E Tolino
(E)
G Tonini
(G)
M Talamonti
(M)
Informations de copyright
© 2023 European Academy of Dermatology and Venereology.
Références
Fölster-Holst R. Management of atopic dermatitis: are there differences between children and adults? J Eur Acad Der- Matol Venereol. 2014;28(Suppl 3):5-8.
Williams HC. Clinical practice. Atopic dermatitis. N Engl J Med. 2005;352(22):2314-2324.
Radi G, Campanti A, Diotallevi F, Martina E, Marani A, Offidani A. A systematic review of atopic dermatitis: the intriguing journey starting from physiopathology to treatment, from laboratory bench to bedside. Biomedicine. 2022;10(11):2700.
Nettis E, Ortoncelli M, Pellacani G, Foti C, Di Leo E, Patruno C, et al. A multicenter study on the prevalence of clinical patterns and clinical phenotypes in adult atopic dermatitis. J Investig Allergol Clin Immunol. 2020;30(6):448-450.
Campanati A, Bianchelli T, Gesuita R, Foti C, Malara G, Micali G, et al. Comorbidities and treatment patterns in adult patients with atopic dermatitis: results from a nationwide multicenter study. Arch Dermatol Res. 2022;314(6):593-603.
Dao H Jr, Kazin RA. Gender differences in skin: a review of the literature. Gend Med. 2007;4(4):308-328.
Kunz B, Oranje AP, Labrèze L, Stalder JF, Ring J, Taïeb A. Clinical validation and guidelines for the SCORAD index: consensus report of the European Task Force on Atopic Dermatitis. Dermatology (Basel, Switzerland). 1997;195(1):10-19.
Hanifin JM, Thurston M, Omoto M, Cherill R, Tofte SJ, Graeber M, et al. The eczema area and severity index (EASI): assessment of reliability in atopic dermatitis. EASI Evaluator Group. Exp Dermatol. 2001;10(1):11-18.
Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI) - a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19(3):210-216.
Yosipovitch G, Reaney M, Mastey V, Eckert L, Abbé A, Nelson L, et al. Peak pruritus numerical rating scale: psychometric validation and responder definition for assessing itch in moderate-to-severe atopic dermatitis. Br J Dermatol. 2019;181(4):761-769.
Patruno C, Amerio P, Chiricozzi A, Costanzo A, Cristaudo A, Cusano F, et al. Optimizing a clinical guidance for diagnosis of atopic dermatitis in adults: joint recommendations of the Italian Society of Dermatology and Venereology (SIDeMaST), Italian Association of Hospital Dermatologists (ADOI), and Italian Society of Allergological, Occupational and Environmental Dermatology (SIDAPA). G Ital Dermatol Venereol. 2020;155(1):1-7.
Campanati A, Marani A, Martina E, Diotallevi F, Radi G, Offidani A. Psoriasis as an immune-mediated and inflammatory systemic disease: from pathophysiology to novel therapeutic approaches. Biomedicine. 2021;9(11):1511.
Davis DMR, Drucker AM, Alikhan A, Bercovitch L, Cohen DE, Darr JM, et al. American Academy of Dermatology Guidelines: awareness of comorbidities associated with atopic dermatitis in adults. J Am Acad Dermatol. 2022;86(6):1335-1336.e18.
Johansson EK, Bergström A, Kull I, Melén E, Jonsson M, Lundin S, et al. Prevalence and characteristics of atopic dermatitis among young adult females and males-report from the Swedish population-based study BAMSE. J Eur Acad Dermatol Venereol. 2022;36(5):698-704.
Krul AJ, Daanen HA, Choi H. Self-reported and measured weight, height and body mass index (BMI) in Italy, The Netherlands and North America. Eur J Public Health. 2011;21(4):414-419.
Ibrahim Q, Ahsan M. Measurement of visceral fat, abdominal circumference and waist-hip ratio to predict health risk in males and females. Pak J Biol Sci. 2019;22(4):168-173.
Giampaoli S, Palmieri L, Donfrancesco C, Lo Noce C, Pilotto L, Vanuzzo D, et al. Cardiovascular health in Italy. Ten-year surveillance of cardiovascular diseases and risk factors: Osservatorio Epidemiologico Cardiovascolare/Health Examination Survey 1998-2012. Eur J Prev Cardiol. 2015;22(2 Suppl):9-37.
Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH guidelines for the management of arterial hypertension. Eur Heart J. 2018;39(33):3021-3104.
Megna M, Napolitano M, Patruno C, Villani A, Balato A, Monfrecola G, et al. Systemic treatment of adult atopic dermatitis: a review. Dermatol Ther (Heidelb). 2017;7(1):1-23.
Weber-Schoendorfer C, Chambers C, Wacker E, Beghin D, Bernard N, on behalf of the Network of French Pharmacovigilance Centers, et al. Pregnancy outcome after methotrexate treatment for reumatic disease prior to or during early pregnancy. Arthritis Rheumatol. 2012;66(5):1101-1110.
Bertakis KD, Azari R, Helms LJ, Callahan EJ, Robbins JA. Gender differences in the utilization of health care services. J Fam Pract. 2000;49(2):147-152.
Van der Schoot LS, van den Reek JMPA, Groenewoud JMM, Otero ME, Njoo MD, Ossenkoppele PM, et al. Female patients are less satisfied with biological treatment for psoriasis and experience more side-effects than male patients: results from the prospective BioCAPTURE registry. J Eur Acad Dermatol Venereol. 2019;33(10):1913-1920.
Koutroulis I, Papoutsis J, Kroumpouzos G. Atopic dermatitis in pregnancy: current status and challenges. Obstet Gynecol Surv. 2011;66(10):654-663.
Twigg MJ, Lupattelli A, Nordeng H. Women's beliefs about medication use during their pregnancy: a UK perspective. Int J Clin Pharmacol. 2016;38:968-976.
Patruno C, Fabbrocini G, Longo G, Argenziano G, Ferrucci SM, Stingeni L, et al. Effectiveness and safety of long-term Dupilumab treatment in elderly patients with atopic dermatitis: a multicenter real-life observational study. Am J Clin Dermatol. 2021;22(4):581-586.
Patruno C, Napolitano M, Argenziano G, Peris K, Ortoncelli M, Girolomoni G, et al. Dupilumab therapy of atopic dermatitis of the elderly: a multicentre, real-life study. J Eur Acad Dermatol Venereol. 2021;35(4):958-964.
Napolitano M, Ruggiero A, Fontanella G, Fabbrocini G, Patruno C. New emergent therapies for atopic dermatitis: a review of safety profile with respect to female fertility, pregnancy, and breastfeeding. Dermatol Ther. 2021;34(1):e14475.
Balakirski G, Novak N. Atopic dermatitis and pregnancy. J Allergy Clin Immunol. 2022;149(4):1185-1194.
Mina S, Jabeen M, Singh S, Verma R. Gender differences in depression and anxiety among atopic dermatitis patients. Indian J Dermatol. 2015;60(2):211.
Holm EA, Esmann S, Jemec GBE. Does visible atopic dermatitis affect quality of life more in women than in men? Gend Med. 2004;1(2):125-130.