Lifelong Impact of Severe Atopic Dermatitis on Quality of Life: A Case Report

Abstract

Severe, uncontrolled atopic dermatitis (AD) persisting from childhood to adulthood can have enduring quality of life (QoL) impacts on daily functioning, academics, career, family and social life, and mental health. In addition, AD has an impact on direct and indirect healthcare resource utilization. Several studies have attempted to quantify the quality of life and direct/indirect economic burden of AD. However, these estimates may not capture the more intangible disease-related burden and associated economic burden. This was a qualitative case report that aimed to investigate the full lifetime impact of severe, uncontrolled AD on all aspects of a single patient's life. This case report emphasizes the enormous cumulative lifetime impact of severe, uncontrolled AD and where the qualitative indirect impact may not be fully captured. After obtaining consent, a patient, diagnosed with severe AD since birth, was asked close-and open-ended questions about AD history, direct and indirect healthcare resource utilization, and impact of AD on work, home, family, social life, daily functioning, and mental health over the course of her lifetime. Our patient attributed her severe, uncontrolled AD since birth to causing poor sleep quality, depression, anxiety, and difficulty with social connections and to her choosing an alternative, less physically demanding career. Early effects on sleep and school performance, along with impact on social connections, likely contribute to weaker career opportunities and further social isolation with age.

Publication Trends of Qualitative Research in Dermatology

“…Figure 1 shows the PRISMA flow diagram of the selection criteria. A total of 1398 studies were screened, and 249 studies (17.8%) were ultimately included in the database …”

How does atopic dermatitis in childhood and adolescence affect educational success?

“…As mentioned by Basyham et al ., 3 AD flares may result in missing days at school by hospitalization or doctor’s appointments. Even at days with school attendance, visits at the school nurse’s office may take place due to sudden skin detoriation leading to additional reduction in school participation 3 . Resulting itching and pain from AD lesions can work as distractors, hereby disturbing concentration at school or academic training 3 …”

“…3 Resulting itching and pain from AD lesions can work as distractors, hereby disturbing concentration at school or academic training. 3 In this issue of JEADV, P alsson et al 4 report on a decreased chance of completing basic compulsory education and further academic education in mild and moderate AD patients in childhood and adolescence from Denmark. Severe AD in childhood and adolescence was associated with a reduced chance to complete further academic education, further vocational education and higher education (master level).…”

“…Even at days with school attendance, visits at the school nurse's office may take place due to sudden skin detoriation leading to additional reduction in school participation. 3 Resulting itching and pain from AD lesions can work as distractors, hereby disturbing concentration at school or academic training. 3 In this issue of JEADV, P alsson et al 4 report on a decreased chance of completing basic compulsory education and further academic education in mild and moderate AD patients in childhood and adolescence from Denmark.…”

“…Even at days with school attendance, visits at the school nurse’s office may take place due to sudden skin detoriation leading to additional reduction in school participation 3 . Resulting itching and pain from AD lesions can work as distractors, hereby disturbing concentration at school or academic training 3 …”