Correlation of disease severity and quality of life (using scoring atopic dermatitis index and Filipino translation of children's dermatology life quality index-cartoon version) in children with atopic dermatitis

BACKGROUND: Atopic dermatitis is a chronic, relapsing inflammatory condition of the skin that is commonly diagnosed among infants and children. Although it is known that AD can affect the quality of life of children, there is ambiguous information about the relationship of disease severity and quality of life in children with AD. To the best of our knowledge, such correlation study has not yet been conducted within the Philippine population.OBJECTIVE: To determine if disease severity using Scoring Atopic Dermatitis (SCORAD) index and quality of life using the Filipino translation of the Children's Dermatology Life Quality Index (CDLQI)-cartoon version is correlated in Filipino children with ADMETHOD: Children aged 4-12 years diagnosed with atopic dermatitis at the outpatient dermatology clinic of a tertiary government hospital were recruited in the study. The severity of their disease was assessed by the investigator using the SCORAD index. Quality of life was evaluated using the Filipino translation of the CDLQI-cartoon version. Both were measured at initial consultation and at the follow-up visit one month after. The relationship between these parameters was statistically analyzed using Spearman's correlation.RESULTS: Forty children were included in the analysis. The mean SCORAD index was 41.08 (SD= +16.54) at baseline and 14.3 (SD = +8.52) on follow-up, while the mean CDLQI score was 12.92 (SD = +5.64) at baseline and 3.35 (SD = +1.98) on follow-up. Majority of the participants had moderate negative effect on QOL at baseline and only a small negative effect on follow-up. Spearman's correlation showed a high positive correlation between the SCORAD index and CDLQI both at initial consultation (Spearman's p= 0.8647) and follow-up visit (Spearman's p= 0.8058). Majority of the children were affected by symptoms of pruritus and sleep disturbance.CONCLUSIONS: Disease severity (using SCORAD index) and quality of life (using the Filipino translation of the CDLQI-cartoon version) were positively correlated among Filipino children with AD. The Filipino translation of the CDLQI-cartoon version is a valid tool which may be used as an additional subjective measure to the clinical objective scoring tools used in the assessment of AD in the Philippines.

Secondary syphilis in a 15-year old male

We report a case of a 15 year-old male who presented with multiple erythematous,non-tender, annular plaques on the penis, scrotal area, face, scalp, hands and feet and a reactive RPR test. Biopsy revealed a marked irregular psoriasiform hyperplasia of the stratum malphigii and permeation of the epidermis with neutrophils and lymphocytes. The dermis shows a moderately dense lichenoid or band-like inflammatory infiltration consisting of innumerable plasma cells, histiocytes, neutrophils and some lymphocytes. There is also noted mild superficial and deep perivascular as well as periappendageal inflammatory infiltration. The inflammatory cells around the appendages consist if plasma cells, histiocytes and few lymphocytes. The blood vessels are shown to have endothelial cells swelling with mild extravasated red blood cells. The diagnosis was secondary syphilis. The patient was treated with a single dose of benzathine penicillin G 1.8 M units intramuscularly. Marked improvement of the lesions was noted after 1 week.