Quality of Life in Children and Adolescents with Atopic Dermatitis

소아청소년 아토피피부염 환자의 삶의 질

  • Cho, Soo Ick (Department of Dermatology, College of Medicine, Hallym University) ;
  • Kim, Jin Hye (Department of Dermatology, College of Medicine, Hallym University) ;
  • Chung, Bo Young (Department of Dermatology, College of Medicine, Hallym University) ;
  • Ahn, In Su (Department of Dermatology, College of Medicine, Hallym University) ;
  • Kim, Hye One (Department of Dermatology, College of Medicine, Hallym University) ;
  • Park, Chun Wook (Department of Dermatology, College of Medicine, Hallym University) ;
  • Lee, Cheol Heon (Department of Dermatology, College of Medicine, Hallym University)
  • 조수익 (한림대학교 의과대학 피부과학교실) ;
  • 김진혜 (한림대학교 의과대학 피부과학교실) ;
  • 정보영 (한림대학교 의과대학 피부과학교실) ;
  • 안인수 (한림대학교 의과대학 피부과학교실) ;
  • 김혜원 (한림대학교 의과대학 피부과학교실) ;
  • 박천욱 (한림대학교 의과대학 피부과학교실) ;
  • 이철헌 (한림대학교 의과대학 피부과학교실)
  • Published : 2011.05.31

Abstract

Background: The symptoms of atopic dermatitis (AD) can limit a patient's physical and psychosocial development as well as lower their overall quality of life (QOL). These problems may have a greater effect on patients during childhood and adolescence, whose physical and psychosocial developments are vigorously ongoing. Objective: The purpose of this study was to identify the correlation between the QOL and clinical disease severity in children and adolescents with AD. Methods: Forty-six AD patients aged from 7 to 18 years were included in this study. A questionnaire based on Children's Dermatology Life Quality Index (CDLQI) was used to determine QOL. Eczema area and severity index (EASI) were examined to evaluate the severity of AD. Results: The mean score of CDLQI was 12.83${\pm}$6.52. Among the 10 categories, itching, treatment, and sleep showed the highest scores, whereas teasing, friendships, and school or holiday work had the lowest scores (p<0.01). The mean EASI score was 8.51${\pm}$8.64. CDLQI and EASI scores showed significant correlation (p<0.001). Among the 10 categories of CDLQI and EASI score, the sleep, itching, and clothes categories displayed high correlation with the EASI score (p<0.001). There was no statistically significant difference between the different age groups or between boys and girls. Patients with head and neck skin lesions showed problems with personal relationships and treatment (p<0.05). Conclusion: AD affects the QOL of children and adolescents with AD as the severity of the disease increases. In managing AD patients, not only evaluating the clinical severity of the disease but also evaluating QOL is necessary, and emotional support could be helpful to increase the QOL of childhood and adolescent AD patients.

Keywords

References

  1. Williams HC, Wuthrich B. The natural history of atopic dermatitis, In: Williams HC, editor. Atopic dermatitis: the epidemiology, causes, and prevention of atopic eczema. 1st ed. Cambridge, United Kingdom: Cambridge University Press, 2001:41-59
  2. Lee HS, Kim JS, Pyun BY. Changes of the prevalence and the allergens of atopic dermatitis in children: from 1992 to 2002. Pediatr Allergy Respir Dis Korea 2002;12:263-270
  3. Schafer T, Ring J. Epidemiology of allergic disease. Allergy 1997;52(Suppl. 38):14-22
  4. Howlett S. Emotional dysfunction, child-family relationships and childhood atopic dermatitis. Br J Dermatol 1999:140; 381-384 https://doi.org/10.1046/j.1365-2133.1999.02696.x
  5. Spergel JM, Paller AS. Atopic dermatitis and the atopic march. J Allergy Clin Immunol 2003;112(Suppl):118-27 https://doi.org/10.1016/j.jaci.2003.09.033
  6. Lapidus CS, Kerr PE. Social impact of atopic dermatitis. Med Health R I 2001;84:294-295
  7. Shin NL, Kim SH, Cho SY, Whang KK, Hahm JH. The impact of childhood atopic dermatitis on their families. Korean J Dermatol 2000;38:494-499
  8. Lee HJ, Park CO, Lee JH, Lee KH. Life quality assessment among adult patients with atopic dermatitis. Korean J Dermatol 2007;45:159-164
  9. Park CK, Park CW, Lee CH. Quality of life and the family impact of atopic dermatitis in children. Korean J Dermatol 2007;45:429-438
  10. Kim EJ, Kim HO, Park YM. A study on quality of life and economic burden in Korean patients with atopic dermatitis and their parents. Korean J Dermatol 2008;46: 160-170
  11. Kim SH, Han DH, Park HJ, Byun JY, Choi YW, Choi HY, et al. The relationship between child and adolescent atopic dermatitis, attachment and the quality of parental life. Korean J Dermatol 2008;46:1457-1462
  12. Park YL, Kim HD, Kim KH, Kim MN, Kim JW, RO YS, et al. Report from ADRG: a study on the diagnostic criteria of Korean atopic dermatitis. Korean J Dermatol 2006;44:659-663
  13. Lewis-Jones MS, Finlay AY. The Children's Dermatology Life Quality Index (CDLQI): initial validation and practical use. Br J Dermatol 1995;132:942-949
  14. Bae EJ, Seo SH, Kye YC, Ahn HH. Use of quality of life instruments in original articles of the Korean Journal of Dermatology. Korean J Dermatol 2010;48:179-183
  15. Lewis V, Finlay AY. 10 years experience of the Dermatology Life Quality Index (DLQI). J Investig Dermatol Symp Proc 2004;9:169-180 https://doi.org/10.1111/j.1087-0024.2004.09113.x
  16. Beattie PE, Lewis-Jones MS. A comparative study of impairment of quality of life in children with skin disease and children with other chronic childhood diseases. Br J Dermatol 2006;155:145-151 https://doi.org/10.1111/j.1365-2133.2006.07185.x
  17. Kiebert G, Sorensen SV, Revicki D, Fagan SC, Doyle JJ, Cohen J, et al. Atopic dermatitis is associated with a decrement in health-related quality of life. Int J Dermatol 2002;41:151-158 https://doi.org/10.1046/j.1365-4362.2002.01436.x
  18. Ganemo A, Svensson A, Lindberg M, Wahlgren CF. Quality of life in Swedish children with eczema. Acta Derm Venereol 2007;87:345-349 https://doi.org/10.2340/00015555-0245
  19. Hon KL, Leung TF, Wong KY, Chow CM, Chuh A, Ng PC. Dose age or gender influence quality of life in children with atopic dermatitis? Clin Exp Dermatol 2008;33:705-709 https://doi.org/10.1111/j.1365-2230.2008.02853.x
  20. en-Gashir MA, Seed PT, Hay RJ. Quality of life and disease severity are correlated in children with atopic der- matitis. Br J Dermatol 2004;150:284-290 https://doi.org/10.1111/j.1365-2133.2004.05776.x
  21. Hon KL, Kam WY, Lam MC, Leung TF, Ng PC. CDLQI, SCORAD and NESS: are they correlated? Qual Life Res 2006;15:1551-1558 https://doi.org/10.1007/s11136-006-0019-7
  22. Cork MJ, Danby SG, Vasilopoulos Y, Hadgraft J, Lane ME, Moustafa M, et al. Epidermal barrier dysfunction in atopic dermatitis. J Invest Dermatol 2009;129:1892-1908 https://doi.org/10.1038/jid.2009.133
  23. Staab D, Diepgen TL, Fartasch M, Kupfer J, Lob-Corzilius T, Ring J, et al. Age related, structured educational programmes for the management of atopic dermatitis in children and adolescents: multicentre, randomised controlled trial. Br Med J 2006;332:932-938 https://doi.org/10.1136/bmj.332.7541.s93-a
  24. Thomson KF, Wilkinson SM, Sommer S, Pollock B. Eczema: quality of life by body site and the effect of patch testing. Br J Dermatol 2002;146:627-630 https://doi.org/10.1046/j.1365-2133.2002.04692.x
  25. Lee SH, Cho HS, Seung NR, Jung SJ, Kim CW, Jo HJ, et al. Quality of life of acne patients. Korean J Dermatol 2006;44:688-695
  26. Jeon EK, Park YO, Seo YJ, Lee JH, Park JK. Assessment of the quality of life in vitiligo patients. Korean J Dermatol 2008;46:874-880
  27. Cho TH, Hong SB, Ryou JH, Lee MH. Quality of life in melasma. Korean J Dermatol 2007;45:232-236
  28. Cho SE, Jeon JE, Cho HN, Son DK, Kim HO, Lee SH, et al. Psychological intervention in an integrated health care service for children with atopic dermatitis. Korean J Asthma Allergy Clin Immunol 2010;30:100-109
  29. Ehlers A, Stangier U, Gieler U. Treatment of atopic dermatitis: a comparison of psychological and dermatological approaches to relapse prevention. J Consult Clin Psychol 1995;63:624-635 https://doi.org/10.1037/0022-006X.63.4.624