Stressors in Atopic Dermatitis

Barilla, Steven; Felix, Kayla; Jorizzo, Joseph L.

doi:10.1007/978-3-319-64804-0_7

Cited by 11 publications

(7 citation statements)

References 25 publications

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“…These stressors have been shown to impact other quality of life domains, altering sleep patterns, decreasing self-esteem and interfering with interpersonal relationships. 18 It is worth noting that AD financial impact has been reported by our patients as a highly relevant factor, comparable to routine alterations, pain and anxiety. Nearly one fourth of surveyed participants have no healthcare insurance, leading to a low accessibility to treatment due to their high costs.…”

Section: Discussionsupporting

confidence: 55%

“…17 In addition, it is highlighted that AD induces stress, but can also be exacerbated by it. 18 Several AD-associated stressors have been described, including physical discomfort due to itching and altered appearance during AD flare-ups. These stressors have been shown to impact other quality of life domains, altering sleep patterns, decreasing self-esteem and interfering with interpersonal relationships.…”

Section: Discussionmentioning

confidence: 99%

“…These stressors have been shown to impact other quality of life domains, altering sleep patterns, decreasing self-esteem and interfering with interpersonal relationships. 18 …”

Section: Discussionmentioning

confidence: 99%

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Impact of atopic dermatitis on quality of life: a large web-based survey from Argentina

Echeverría¹,

Angles

Larralde

et al. 2022

Rev Fac Cien Med Univ Nac Cordoba

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Background: Atopic dermatitis (AD) is a chronic, recurrent, inflammatory skin condition that is associated with detrimental effects on the lives of patients and their families, including an impact on quality of life (QOL). Studies about QOL on Latin American AD patients are scarce and have generally included few patients. Objective: describing AD impact on the QOL in a large cohort in Argentina. Methods: a structured web-based survey including 1,650 AD pediatric and adult patients was performed. Results: according to retrieved data, AD symptoms onset started during childhood in most patients, but 20 % of participants reported that manifestations of AD were initially perceived during late adolescence and adulthood. Important differences were observed among country regions, with a shorter time-to-diagnosis in most populated and richer districts. Main affected domains included frustration, anger, mood alterations, stress, sleep alterations, routine alterations, pain and economic impact of AD. Limitations: biases inherent to survey design. Conclusions: we consider that our study contributes to a better understanding of AD in Argentina, as well as its physical, social and financial impact on affected patients.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

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Impact of atopic dermatitis on quality of life: a large web-based survey from Argentina

Echeverría¹,

Angles

Larralde

et al. 2022

Rev Fac Cien Med Univ Nac Cordoba

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“…Children whose skins are disfigured by AD often experience discrimination or stigmatisation (Chernyshov, ). Previous research has suggested that children living with AD have behavioural problems and experience psychological disturbances, especially psychological stress (Barilla, Felix, & Jorizzo, ), anxiety, depression (Cheng et al, ) and attention deficit hyperactivity disorder (ADHD; Lee et al, ). Generally, children living with AD have a significantly lower quality of life than their healthy peers (Lifschitz, ).…”

Section: Introductionmentioning

confidence: 99%

The wounded self—lonely in a crowd: A qualitative study of the voices of children living with atopic dermatitis in Hong Kong

Xie

Chan

2020

Health Soc Care Community

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Atopic dermatitis (AD) imposes significant physical and psychosocial burdens on affected children. However, little has been done to learn from the subjective experiences, perspectives and emotions of children living with AD. Their voices are not heard in healthcare settings. This study aims to share these children's voices and provide a deep understanding of the subjective experiences of children living with AD. We conducted qualitative research by conducting semi‐structured interviews and analysing the drawings of 17 children in Hong Kong aged between 8 and 12 years who were diagnosed with AD. Using a phenomenological approach, we transcribed, coded and described the interviews. We found that for the children in this study, living with AD meant contending with an accumulation of challenges and crises. At the individual level, the essential experience of living with AD manifested a vicious cycle of skin and mental issues. At the family level, conflicts between children and parents concerning AD management coexisted with parental support. The children commonly experienced bullying and isolation in school and discrimination and stigmatisation in their neighbourhood, thereby making living with AD a traumatic experience. The synergy between individual and environmental factors contributed to shaping an incapable and wounded “self” living with AD. Based on our findings, we propose a child‐centred biopsychosocial framework for understanding the living experiences of children with AD. This study suggests different practice strategies for healthcare professionals working with the individual challenges experienced by children living with AD and the challenges these children experience in their family, school, and neighbourhood. The needs of these children should be addressed through an integrated, holistic approach for improving their long‐term health outcomes.

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“…Moreover, optimal AD mouse models should be predictive for clinical treatment outcomes, should permit to elucidate which key signals suffice to induce AD lesions in healthy human skin in vivo and to trigger AD lesions by psychoemotional (perceived) stress 4 -just as in many AD patients, 5,6 in whom psychological interventions can be beneficial. [7][8][9] These desirable prerequisites of clinically relevant AD mouse models 4 favor the use of human skin xenografts on immunocompromised mice.…”

Section: Introductionmentioning

confidence: 99%

Autologous Th2‐polarized lymphocytes induce atopic dermatitis lesions in non‐atopic human skin xenotransplants

Keren

Reich

Bertolini

et al. 2023

Allergy

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Background:The key signals that suffice to induce atopic dermatitis (AD) in human skin remain incompletely understood. Also, current mouse models reflect human AD only unsatisfactorily. Therefore, we have asked whether a humanized AD mouse model can be developed that reflects human AD more faithfully and permit to identify key signals that suffice to induce AD lesions in previously healthy human skin in vivo. Methods: Healthy human skin from non-atopic donors was transplanted onto SCID/ beige mice. After xenotransplant reinnervation by mouse sensory nerve fibers had occurred, mixed autologous human Th2 CD4+ and Tc2 CD8+ T cells that had been pretreated in vitro with IL-2, IL-4, and LPS were injected intradermally into the xenotransplants without skin barrier disruption. Results: Injected non-atopic xenotransplants rapidly developed a morphological, functional, and immunological phenocopy of human AD lesions regarding skin barrier defects, immunopathology including intraepidermal eosinophils, mast cell activation, increase of thymic stromal lymphopoietin, eotaxin-1 and type 2 cytokine circuits, and even showed characteristic neuroimmunological abnormalities such as ß2-adrenergic receptor downregulation. The experimentally induced AD lesions in human skin responded to standard AD therapy (topical dexamethasone or tacrolimus; systemic anti-IL-4Rα antibody [dupilumab]), and relapsed when neurogenic skin inflammation was induced by exposing mice to perceived stress. Conclusions: This new animal model uniquely mimics the complexity of human AD and its clinical response to standard therapy and psychoemotional stressors in vivo, and shows that Th2-polarized lymphocytes associated with excessive IL-4Rα-mediated signaling suffice to induce human AD skin lesions, while atopy and epidermal barrier disruption are dispensable.

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Stressors in Atopic Dermatitis

Cited by 11 publications

References 25 publications

Impact of atopic dermatitis on quality of life: a large web-based survey from Argentina

Impact of atopic dermatitis on quality of life: a large web-based survey from Argentina

The wounded self—lonely in a crowd: A qualitative study of the voices of children living with atopic dermatitis in Hong Kong

Autologous Th2‐polarized lymphocytes induce atopic dermatitis lesions in non‐atopic human skin xenotransplants

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