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Atopic Dermatitis: A Qualitative Study on the Burdens of Living with Itchiness
Ashley M Snyder1,2, Vanina L Taliercio1, Adelheid U Brandenberger3
1Drs. Snyder, Taliercio, Webber, Beshay, Rhoads, and Secrest are with the Department of Dermatology at the University of Utah in Salt Lake City, Utah.
Objective:
We sought to understand the consequences itchiness has on daily life that may not be immediately obvious in clinical assessments for patients with atopic dermatitis (AD).
Methods:
Focus groups and interviews involving 21 patients with AD and 12 family members examined aspects of the effects of itchiness on health-related quality of life (HRQL). Investigators conducted a thematic analysis where two researchers independently coded the narratives and arrived at a consensus on major themes.
Results:
Five themes emerged from our discussions. 1) Miserable experience: Itchiness was difficult to control and cease. 2) Physical damage: Damage to skin and hair occurred from scratching to alleviate the itchiness. 3) Effects on daily activities: Itchiness could affect everything participants did, including how they dressed, used make-up, and slept. 4) Effects on social activities and relationships: The discomfort and embarrassment from scratching in public and others' reactions hindered participants' social lives. 5) Emotional consequences: Various emotional responses to itchiness were reported, including embarrassment, depression, and irritation.
Limitations:
Though qualitative research provides a level of detail not often found in quantitative analyses, this study design is limited by small sample size and generalizability.
Conclusion:
Understanding these challenges can help clinicians open deeper conversations with their patients to learn more about what patients need from their dermatologic care. While itchiness from AD is well-known, this study shows that its effects on HRQL are not minimal and that patients may need further care for the consequences of this symptom.
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