The Family Impact of Atopic Dermatitis in the Pediatric Population: Results from an International Cross-sectional Study

Barbarot, S.; Silverberg, Jonathan I.; Gadkari, Abhijit; Simpson, Eric L.; Weidinger, Stephan; Mina‐Osorio, Paola; Rossi, Ana B.; Brignoli, Lysel; Mnif, Tarek; Guillemin, Isabelle; Fenton, Miriam C.; Pellan, Marine; Mahajan, Pooja; Delevry, Dimittri; Bansal, Ashish; Eckert, Laurent

doi:10.1016/j.jpeds.2022.04.027

Cited by 33 publications

(19 citation statements)

References 34 publications

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“…Participants were enrolled according to age (6–11 years), ISAAC criteria (presence of itchy rashes for at least 6 months in the past year, and affecting the inside of the elbows, the region around the knees/ankles, under the buttocks, or around the neck, ears, or eyes), 33 self-reporting an AD diagnosis by a healthcare professional and a POEM disease severity score ≥8. 26 , 33 , 34 …”

Section: Methodsmentioning

confidence: 99%

“…Parents may lose workdays or be less productive at work due to poor quality of sleep. [22][23][24][25][26] In the year 2000, the point prevalence of AD in Italian schoolchildren was estimated to be 5.8% (with a lifetime prevalence of 15.2%) and was strongly associated with the presence of AD in at least one parent. 27 In the last few decades, the Italian scientific community has committed to the diagnosis, management, and understanding of the burden of AD in children, adolescents, and adults.…”

Section: Introductionmentioning

confidence: 99%

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Implications of Atopic Dermatitis on the Quality of Life of 6–11 Years Old Children and Caregivers (PEDI-BURDEN)

Neri¹,

Galli²,

Baiardini³

et al. 2023

JAA

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Purpose Atopic dermatitis (AD) is a chronic, relapsing and remitting inflammatory skin disease characterized by intense itch. The disease burden includes physical limitations, psychosocial discomfort, and a reduced quality of life (HRQoL). This study presents the results of a parent-reported survey on the psychosocial impact of AD on Italian pre-adolescent children (6–11 years old), with a specific focus on bullying, self-isolation, absenteeism, and presenteeism. Methods An online questionnaire was sent to 3067 random recipients and 160 matched the inclusion criteria for age, self-reported AD diagnosis, localizations (according to ISAAC), and disease severity (POEM ≥8). 100 children, with comparable ages, not matching the inclusion criteria for AD, were recruited as a control group. Results Children with AD and their caregivers had a significantly lower quality of sleep (QoS) compared to the control group. The presence of AD was directly responsible for many restless nights, both in children and caregivers (58.9 and 55.4 respectively). Children with AD and their parents also experienced significantly more daytime drowsiness (43.6 and 54.6 days, respectively). Children with AD were more frequently victims of bullying at school (20.0% vs 9.0%; p≤0.05) or in other social environments (16.9% vs 3.0%; p≤0.05). AD caused 17.7 days of absenteeism and 20.1 days of presenteeism per student over the previous 12 months, accounting for 37.8 days of study impairment overall. Severe/very severe AD had a significantly greater impact on presenteeism than moderate AD (25.1 vs 17.5 days; p≤0.05). Presenteeism, which was more pronounced among bullied students, was positively correlated with absenteeism only in the AD cohort. Conclusion AD has a detrimental impact on the HRQoL of pediatric patients, causing stigmatization and social isolation. Functional distress was also reported by caregivers. Our study might inform the public and policymakers about the disease burden of AD at a young age.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Implications of Atopic Dermatitis on the Quality of Life of 6–11 Years Old Children and Caregivers (PEDI-BURDEN)

Neri¹,

Galli²,

Baiardini³

et al. 2023

JAA

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“…As the first manifestation during atopic march, AD is a chronic inflammatory skin disease that occurs in infancy. More than 60% of children with AD developed eczema in the first 12 months of their life ( 8 ). Lesional skin of patients with AD is characterized by erythematous scaling plaques, eczema, xerosis and intense pruritus ( 9 ), with infiltration of type 2 innate lymphoid cells (ILC2s), T cells, eosinophils, and mast cells ( 10 ).…”

Section: The Atopic Marchmentioning

confidence: 99%

Claudin-1 Mediated Tight Junction Dysfunction as a Contributor to Atopic March

Xia

Cao²,

Zheng³

2022

Front. Immunol.

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Atopic march refers to the phenomenon wherein the occurrence of asthma and food allergy tends to increase after atopic dermatitis. The mechanism underlying the progression of allergic inflammation from the skin to gastrointestinal (GI) tract and airways has still remained elusive. Impaired skin barrier was proposed as a risk factor for allergic sensitization. Claudin-1 protein forms tight junctions and is highly expressed in the epithelium of the skin, airways, and GI tract, thus, the downregulation of claudin-1 expression level caused by CLDN-1 gene polymorphism can mediate common dysregulation of epithelial barrier function in these organs, potentially leading to allergic sensitization at various sites. Importantly, in patients with atopic dermatitis, asthma, and food allergy, claudin-1 expression level was significantly downregulated in the skin, bronchial and intestinal epithelium, respectively. Knockdown of claudin-1 expression level in mouse models of atopic dermatitis and allergic asthma exacerbated allergic inflammation, proving that downregulation of claudin-1 expression level contributes to the pathogenesis of allergic diseases. Therefore, we hypothesized that the tight junction dysfunction mediated by downregulation of claudin-1 expression level contributes to atopic march. Further validation with clinical data from patients with atopic march or mouse models of atopic march is needed. If this hypothesis can be fully confirmed, impaired claudin-1 expression level may be a risk factor and likely a diagnostic marker for atopic march. Claudin-1 may serve as a valuable target to slowdown or block the progression of atopic march.

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“…AD in childhood and adolescence has a negative impact on the quality of life (QoL) of the parents and caregivers of affected children [10][11][12][13]. Moderate-to-severe AD in children is often associated with a significant symptom burden, including pruritus, pain, and sleep disturbance, which may result in poor self-esteem, reduced school performance, and increased familial stress [14].…”

Section: Introductionmentioning

confidence: 99%

“…The Epidemiology of Children with Atopic Dermatitis Reporting on their Experience (EPI-CARE) study evaluated the prevalence and burden of AD among the pediatric population (aged 6 months to <18 years) and their caregivers in countries from several geographic regions worldwide, including Japan [19]. Data from the EPI-CARE study have indicated that parents and caregivers experience an impact of their child's AD on family QoL, particularly in children with higher disease severity [13]. In the Japanese EPI-CARE pediatric population (n = 5702), the 12-month prevalence of diagnosed AD (based on meeting the International Study of Asthma and Allergies in Childhood (ISAAC) criteria [20] and having a physician-diagnosed AD) was 10.7% overall, 12.9% in patients aged <6 years, 10.3% in those aged 6 to <12 years, and 9.1% in those aged 12 to <18 years [19].…”

Section: Introductionmentioning

confidence: 99%

Impact of the Family and Household Environment on Pediatric Atopic Dermatitis in Japan

Saeki

Ohya

Nawata

et al. 2023

JCM

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Pediatric atopic dermatitis (AD) can negatively impact the family quality of life (QoL). We report data from the real-world Epidemiology of Children with Atopic Dermatitis Reporting on their Experience (EPI-CARE) study in Japanese pediatric patients, focusing on disease impact on family QoL. Children and adolescents aged 6 months to <18 years completed an online survey between September 2018–December 2019. The impact of disease severity on family QoL and its effect on parents’ time were assessed using the dermatitis family impact (DFI) questionnaire. The impact of a family history of allergic conditions, current residency, second-hand smoke exposure, and household pets on AD prevalence and severity was also assessed. Family QoL decreased as AD severity increased, particularly in families with children aged <6 years; but had the greatest impact on sleep and tiredness in families with children aged <12 years. Parents spent at least 4.6 h/week caring for children <6 years, including those with mild symptoms. Most children (>80%) had a family history of allergic conditions; AD prevalence was increased in those exposed to second-hand smoke or household pets. This study demonstrated that pediatric AD in Japanese individuals has negative impacts on family QoL and that family and household environments can influence pediatric AD prevalence.

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The Family Impact of Atopic Dermatitis in the Pediatric Population: Results from an International Cross-sectional Study

Cited by 33 publications

References 34 publications

Implications of Atopic Dermatitis on the Quality of Life of 6–11 Years Old Children and Caregivers (PEDI-BURDEN)

Implications of Atopic Dermatitis on the Quality of Life of 6–11 Years Old Children and Caregivers (PEDI-BURDEN)

Claudin-1 Mediated Tight Junction Dysfunction as a Contributor to Atopic March

Impact of the Family and Household Environment on Pediatric Atopic Dermatitis in Japan

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