Impact on Major Life-changing Decisions in Patients with Atopic Dermatitis

Atopic dermatitis (AD) is a chronic skin disease that significantly affects patients' quality of life. While other dermatological conditions like psoriasis are known to impact major life-changing decisions (MLCD), no prior studies have evaluated this in AD. A descriptive cross-sectional study was conducted in patients with AD of at least 6 months' duration. Sociodemographic and clinical characteristics of the patients, as well as severity from both the physician's and patient's point of view, were assessed using different rating scales such as the Eczema Area and Severity Index (EASI). Subsequently, patients were divided according to disease severity into severe AD (EASI ≥ 21) or mild-moderate AD (EASI < 21). Life decisions were evaluated across several areas, including work, education, social life, reproduction, recreation, housing, and lifestyle, using a 4-point Likert scale. A total of 104 patients, with an average disease duration of 20.36 years, were included. The results showed significant MLCD impairment, especially in clothing choices (52.9%), lifestyle (48.1%), and sports activities (41.4%). Severe AD was associated with greater social and emotional challenges, such as difficulties in social interactions (48.6% vs 26.1%) and romantic relationships (48.5% vs 18.8%) compared with mild-moderate AD. These findings highlight the profound impact of AD on daily life, emphasizing the need for comprehensive management strategies that address physical, psychological, and social aspects.