Atopic eczema: burden of disease and individual suffering – results from a large EU study in adults

Abstract

Background Atopic eczema (AE, atopic dermatitis) is one of the most common non‐communicable inflammatory skin diseases affecting 1–5% of the adult population in Europe with marked impairment in quality of life. In spite of great progress in understanding the pathophysiology of disturbed skin barrier and immune deviation, AE still represents a problem in daily clinical practice. Furthermore, the true impact of AE on individual suffering is often not recognized. Objectives With a large European study, we wanted to provide insights into the actual suffering and individual burden of disease in adult patients with AE. Methods A total of 1189 adult patients (18–87 years, 56% female) with moderate to severe AE were recruited in nine European countries by dermatologists or allergists together with the help of patient organizations. A computer‐assisted telephone interview was performed by experienced interviewers between October 2017 and March 2018. The following instruments were used to assess severity or measure quality of life: Patient‐Oriented Eczema Measure (POEM), Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS‐D) and a newly developed Atopic Eczema Score of Emotional Consequences (AESEC). Patients were also asked to self‐assess the severity of their disease. Results Despite current treatment, 45% of participants still had actual moderate to very severe AE in POEM. Due to their skin disease, 57% missed at least 1 day of work in the preceding year. DLQI showed moderate to extremely large impairment in 55%. According to HADS‐D, 10% scored on or above the threshold of eight points with signs of depressive symptoms. Assessed with AESEC, 57% were emotionally burdened with feelings such as ‘trying to hide the eczema’, ‘feeling guilty about eczema’, having ‘problems with intimacy’ and more. Of persons actually suffering from severe AE, 88% stated that their AE at least partly compromised their ability to face life. Conclusions This real‐life study shows that adults with a moderate to severe form of AE are suffering more than what would be deemed acceptable. There is a need for increased awareness of this problem among healthcare professionals, policymakers and the general public to support research in the development of new and more effective treatments and provide access to better and affordable health care for affected patients.

Depression, anxiety and quality of life in subjects with atopic eczema in a population‐based cross‐sectional study in Germany

“…A total of 4.2% of subjects from the LIFE cohort reported on history of physician diagnosed AE, which was within a comparable range of previous data or estimations . However, in a Swedish population‐based questionnaire study with 34 313 participants the self‐reported prevalence of AE was as high as 14% and adults with AE had an increased risk for severe depression and anxiety …”

“…Atopic eczema (AE, atopic dermatitis) is an inflammatory skin disease that affects between 10% and 35% of children while the prevalence in adults is estimated to be around 3–5% in the general population …”

“…Another paper investigated health insurance data, showing about 15% of subjects with AE being also diagnosed (ICD‐10 code) with depression (prevalence rate 1.41 [CI 1.38; 1.45] . Only recently, reports from a large European study on 1189 adult patients with AE showed scores indicating depression in 10% of patients, and 55% reported to suffer from effects of AE on health‐related QoL . About 15% of them were from Germany .…”

“…Only recently, reports from a large European study on 1189 adult patients with AE showed scores indicating depression in 10% of patients, and 55% reported to suffer from effects of AE on health‐related QoL . About 15% of them were from Germany . Suicidal ideation was reported to occur as a consequence of depression and anxiety …”

“…Atopic eczema (AE, atopic dermatitis) is an inflammatory skin disease that affects between 10% and 35% of children while the prevalence in adults is estimated to be around 3-5% in the general population. [1][2][3][4][5] Over the last years, there was increasing awareness on nonatopic comorbidities in patients with AE. 2 Data on comorbidities were shown to differ between geographical regions, that is with regard to cardiovascular comorbidities registered in US but not in European subjects with AE.…”