Lifelong Impact of Severe Atopic Dermatitis on Quality of Life: A Case Report

Severe, uncontrolled atopic dermatitis (AD) persisting from childhood to adulthood can have enduring quality of life (QoL) impacts on daily functioning, academics, career, family and social life, and mental health. In addition, AD has an impact on direct and indirect healthcare resource utilization. Several studies have attempted to quantify the quality of life and direct/indirect economic burden of AD. However, these estimates may not capture the more intangible disease-related burden and associated economic burden. This was a qualitative case report that aimed to investigate the full lifetime impact of severe, uncontrolled AD on all aspects of a single patient's life. This case report emphasizes the enormous cumulative lifetime impact of severe, uncontrolled AD and where the qualitative indirect impact may not be fully captured. After obtaining consent, a patient, diagnosed with severe AD since birth, was asked close- and open-ended questions about AD history, direct and indirect healthcare resource utilization, and impact of AD on work, home, family, social life, daily functioning, and mental health over the course of her lifetime. Our patient attributed her severe, uncontrolled AD since birth to causing poor sleep quality, depression, anxiety, and difficulty with social connections and to her choosing an alternative, less physically demanding career. Early effects on sleep and school performance, along with impact on social connections, likely contribute to weaker career opportunities and further social isolation with age.