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Time spent on treatment of atopic dermatitis: a new method of measuring pediatric morbidity?
Elisabeth A Holm1, G B E Jemec
1Division of Dermatology, Department of Medicine, Roskilde Hospital, Roskilde, Denmark. rselho@ra.dk
Insights
Time spent on treatment (TSOT) is a valuable indicator of pediatric atopic dermatitis (AD) severity. Higher TSOT correlates with higher SCORAD scores, suggesting its utility in assessing childhood eczema burden.
Area of Science:
- Pediatric Dermatology
- Clinical Research
- Atopic Dermatitis Management
Background:
- Atopic dermatitis (AD) significantly impacts children's quality of life.
- Accurate assessment of disease severity is crucial for effective management.
- Existing measures may not fully capture the daily burden on patients and families.
Purpose of the Study:
- To evaluate if Time Spent On Treatment (TSOT) can serve as a reliable surrogate measure for pediatric atopic dermatitis severity.
- To explore the correlation between TSOT and objective disease scoring systems.
Main Methods:
- A cohort of 42 children with atopic dermatitis (AD) was studied.
- Time Spent On Treatment (TSOT), including topical applications, hygiene, and clinic visits, was recorded.
- Objective Scoring Atopic Dermatitis (SCORAD) was assessed at each visit.
- Statistical analysis was performed to correlate TSOT with SCORAD, age, and sex.
Main Results:
- A significant positive correlation was found between TSOT and SCORAD scores across all visits (p < 0.0001).
- No significant correlation was observed between TSOT and patient age or sex.
- Older children (10-15 years) exhibited a lower TSOT/SCORAD ratio than younger children (1-5 years).
Conclusions:
- TSOT is a potentially valuable and practical measure of morbidity in pediatric AD.
- Abnormal TSOT/SCORAD ratios may indicate coping difficulties, suggesting a need for intensified support programs like "eczema schools".
Abstract:
Our purpose was to examine if the time spent on treatment (TSOT) is a relevant surrogate measure of pediatric disease severity. The TSOT (min/day) was studied in a group of 42 children with atopic dermatitis (AD) (16 girls and 26 boys; mean age 7.07 years). The TSOT included time spent on all types of topical treatment, on extra cleaning, and on visits to doctors. Objective Scoring Atopic Dermatitis (SCORAD) assessment was performed at each visit. A significant correlation was found between TSOT and SCORAD scores for all visits (p < 0.0001). There was no correlation between TSOT and age or sex or between TSOT/SCORAD and age (p < 0.08). For the 65 visits (by 42 children), TSOT/SCORAD ranged from 0.08 min/point to 28.67 min/point. Older children (10-15 years of age) had a lower TSOT/SCORAD ratio compared to younger children (1-5 years of age). Our data suggest that TSOT in itself may be a useful measure of morbidity among pediatric AD patients. It is speculated that patients with a very high TSOT/SCORAD rate or a very low rate have coping problems and would therefore be suitable candidates for intensified efforts in programs such as "eczema schools."
