INTRODUCTION
INTRODUCTION Atopic dermatitis (AD), also known as eczema, is a chronic inflammatory relapsing skin disorder that is characterized by pruritus and recurrent eczematous lesions and is a disease that is prevalent in both children and adults.1 AD presents as an erythematous rash and usually involves the skin of face and flexor surfaces.2 The strongest risk factor for AD is a family history of atopic diseases, particularly for atopic dermatitis.3 AD is associated with other atopic responses, such as allergic rhinitis, asthma, and food allergy.4,5 Genetic risk factors for AD include null mutations in filaggrin (FLG), which encodes for a key epidermal structural protein.6 Environmental risk factors include a western diet, living in urban settings with low humidity or UV radiation exposure, a small family size, and a high education level within the household.7
AD is predominantly an early onset disease, with 60% of cases arising in the first year of life.8 According to global burden of skin diseases research in 2010, AD is in the top 10 most prevalent skin diseases worldwide.9 In the United States, the prevalence of AD is 11.3–12.7% in the pediatric and adolescent population, and 6.9–7.6% in the adult population.10 The incidence of AD has increased by 2–3 fold during the past decades.5 AD is a clinical diagnosis, and is diagnosed using various diagnostic criteria, including the Hanifin and Rajka criteria.11 Criteria include pruritus and dermatotic lesions with xerosis or generalized skin dryness.1 Associated features include hyperlinearity of the palms and soles, thinning or complete loss of the lateral one-third of the eyebrows (Herthoge sign), and creases under the lower eyelids (Dennie-Morgan lines), which are strongly associated with AD.1,12,13 To help measure disease severity, quality of life, and long-term control, the Eczema Area Severity Index and the Scoring of Atopic Dermatitis Index are used.14
AD is associated with increased risk of psychosocial stress and development of mental health disorders. It has the greatest impact on disability-adjusted life years (DALY) among amongst all existing dermatological cutaneous disorders.9 AD can impact quality of life as well as the social, academic, and occupational areas of those affected.15 The purpose of this review is to explore the extent and severity of psychosocial burden that patients with atopic dermatitis may experience, with focus on up-to-date treatment options available for symptoms associated with AD.
AD is predominantly an early onset disease, with 60% of cases arising in the first year of life.8 According to global burden of skin diseases research in 2010, AD is in the top 10 most prevalent skin diseases worldwide.9 In the United States, the prevalence of AD is 11.3–12.7% in the pediatric and adolescent population, and 6.9–7.6% in the adult population.10 The incidence of AD has increased by 2–3 fold during the past decades.5 AD is a clinical diagnosis, and is diagnosed using various diagnostic criteria, including the Hanifin and Rajka criteria.11 Criteria include pruritus and dermatotic lesions with xerosis or generalized skin dryness.1 Associated features include hyperlinearity of the palms and soles, thinning or complete loss of the lateral one-third of the eyebrows (Herthoge sign), and creases under the lower eyelids (Dennie-Morgan lines), which are strongly associated with AD.1,12,13 To help measure disease severity, quality of life, and long-term control, the Eczema Area Severity Index and the Scoring of Atopic Dermatitis Index are used.14
AD is associated with increased risk of psychosocial stress and development of mental health disorders. It has the greatest impact on disability-adjusted life years (DALY) among amongst all existing dermatological cutaneous disorders.9 AD can impact quality of life as well as the social, academic, and occupational areas of those affected.15 The purpose of this review is to explore the extent and severity of psychosocial burden that patients with atopic dermatitis may experience, with focus on up-to-date treatment options available for symptoms associated with AD.
DISCUSSION
Emotional and Psychosocial Burden of AD
AD is reported to have the greatest impact on childhood quality
AD is reported to have the greatest impact on childhood quality
