Qualitative analysis of the impact of atopic dermatitis on caregivers

Abstract

burden do not reliably predict response to checkpoint inhibitor therapy. This is likely a multifactorial phenomenon comprised of varying host gene expression profiles, tumour molecular heterogeneity and unique tumour microenvironments. 6 There also exist differences in the anatomical domains of T lymphocytes, with skin-resident T cells being localized and active in the epidermis and high dermis compared with circulating T cells, which are present and functional in the peripheral blood, lymphatics and subdermal soft tissue. 7 Epidermal dysplasia and superficial cSCCs are likely able to evade recognition by circulating T cells, which are probably the group disinhibited by PD-1 inhibitor therapy. The early SCCs may essentially hide from the drug and the systemic immune response in the epidermis.As use of PD-1 inhibitors increases, we will have greater opportunity to observe this phenomenon of a possible epidermal-high dermal privileged tumour microenvironment. It will be useful to examine the impact of T-cell recruitment factors, both genetically determined host drug response and tumour specific, and functional differences in anatomical domains of T lymphocytes in the use of checkpoint inhibitors for keratinocyte carcinoma.

Genetic/Environmental Contributions and Immune Dysregulation in Children with Atopic Dermatitis

“… 10 , 11 The consequences of AD extend to caregivers, who suffer mental and physical health effects tied to the quality of life of these children. 3 , 12 , 13 …”

“…10,11 The consequences of AD extend to caregivers, who suffer mental and physical health effects tied to the quality of life of these children. 3,12,13 AD is a disease of defective genetics in an unfavorable environment. Its underlying mechanisms are largely based in immune dysregulation.…”

Survey of topical exposure concerns for patients and caregivers dealing with atopic dermatitis

“…Despite the recent expansion of treatment options in atopic dermatitis (AD) ( 1 ), most management responsibilities fall on the patient and/or caregivers. Disease control often requires vigilance about and avoidance of common exposures, including environmental triggers, skin care products, topical medications, as well as cleansers and detergents used in the home ( 2 ). However, patients' and caregivers' considerations and concerns about trigger avoidance have not been well enumerated ( 1 ).…”

Caregiver illness beliefs, self-efficacy and severity of atopic dermatitis in the child predict caregiver quality of life

“…4 The negative impact of AD on a child's quality of life (QoL) extends to parents and caregivers 5,6 and affects almost every aspect of the caregiver's life, from physical wellness and the mental burden to work, family and social life. 8 Caring for a child with AD can be a source of stress, 9 and frequently disturbed sleep can cause chronic fatigue with more severe AD having a greater impact, 7 which may affect the caregiver's ability to administer treatments and help their child cope. 10 Therefore it is important to consider what may impact the caregiver's coping strategies and ability to manage their child's condition, such as caregiver self-efficacy (SE).…”