TY - JOUR
T1 - Pain Is a Common and Burdensome Symptom of Atopic Dermatitis in United States Adults
AU - Silverberg, Jonathan I.
AU - Gelfand, Joel M.
AU - Margolis, David J.
AU - Boguniewicz, Mark
AU - Fonacier, Luz
AU - Grayson, Mitchell H.
AU - Chiesa Fuxench, Zelma C.
AU - Simpson, Eric L.
AU - Ong, Peck Y.
N1 - Publisher Copyright:
© 2019 American Academy of Allergy, Asthma & Immunology
PY - 2019/11/1
Y1 - 2019/11/1
N2 - 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.
AB - 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.
KW - Atopic dermatitis
KW - Burden
KW - Eczema
KW - Epidemiology
KW - Itch
KW - Pain
KW - Severity
KW - Sign
KW - Symptom
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U2 - 10.1016/j.jaip.2019.05.055
DO - 10.1016/j.jaip.2019.05.055
M3 - Article
C2 - 31228619
AN - SCOPUS:85068438619
SN - 2213-2198
VL - 7
SP - 2699-2706.e7
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
IS - 8
ER -