The burden of atopic dermatitis

Background: Atopic dermatitis (AD) is a dermatologic condition that affects a large percentage of children and adults in the United States. The disease process is not fully understood, and, currently, there is no cure, so today's treatment methodologies focus on the rash and the symptoms, e.g., pruritus. Even though there is no mortality with this condition, there is significant morbidity and burden. Objective: This review concentrated on several areas in which AD influences quality of life. The areas include sleep, interference with daily activities (e.g., school and/or work), psychological stressors, and the impact on parents and caregivers. The direct and indirect costs of AD are also examined. Methods: A medical literature search was conducted that focused on quality of life (QOL), health-related quality of life, and costs in patients with AD. Results: AD caused poor QOL as assessed in both generic and specific QOL questionnaires. Skin pain was frequently experienced in this condition, which worsens QOL. A significant effect on sleep was found in multiple studies. A large amount of school and/or work absenteeism and psychological stressors was seen in patients with AD. Multiple burdens of the caregivers and parents of patients with AD were documented. Medical costs were also significantly higher compared with patients without AD. Conclusion: The impact of AD is likely more significant than previously acknowledged. AD results in significant morbidity as seen through generic and specific QOL questionnaires, sleep studies, and other questionnaires that measure psychological effects. Physicians should consider evaluating patients with AD beyond their rash and symptoms to achieve the best care possible.