Cutaneous Pain in Atopic Dermatitis: Mental Health Burden

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease that is often associated with cutaneous pain. The objective of this study was to evaluate the impact of cutaneous pain on the prevalence of anxiety, depression, quality of life (QoL) and stigmatization in patients with AD. Methods: A cross-sectional study was conducted on a group of 113 adults with AD (61% females; mean age 34.48 ± 13.20 years). The severity of AD was evaluated using the Eczema Area and Severity Index (EASI). The intensity of cutaneous pain in the past week was measured using a Numerical Rating Scale (NRS), a Short Form McGill Pain Questionnaire (SF-MPQ) and a Visual Analogue Scale (VAS). Psychosocial burden was evaluated using the Hospital Anxiety and Depression Scale (HADS), the Anxiety Generalized Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), the Dermatology Life Quality Index (DLQI) and the 6-Item Stigmatization Scale (6-ISS). Results: Individuals with AD who reported cutaneous pain in the past week scored significantly higher in HADS (p < 0.001), HADS-A (p < 0.001), HADS-D (p = 0.002), GAD-7 (p < 0.001), PHQ-9 (p < 0.001), DLQI (p < 0.001) and 6-ISS (p < 0.001) than the rest of the cohort. More individuals with cutaneous pain had anxiety (36 (48.0%) vs. 7 (18.4%), p = 0.002), depression (21 (28.0%) vs. 2 (5.3%), p = 0.006) and abnormal HADS scores (46 (61.3%) vs. 9 (23.7%), p < 0.001) compared to the rest of participants. Significant correlations were observed between all studied pain assessment tools and all studied psychometric assessments. Conclusions: The prevalence and severity of anxiety, depression, stigmatization, and impaired QoL are higher in adults with AD suffering from cutaneous pain compared to those without pain. This symptom is significantly associated with disease burden.