The Family Impact of Atopic Dermatitis in the Pediatric Population: Results from an International Cross-sectional Study.

OBJECTIVE: To evaluate the impact of atopic dermatitis on families of pediatric patients. STUDY DESIGN: This cross-sectional, web-based survey of children/adolescents (6 months to <18 years old) with atopic dermatitis and their parents and caregivers was conducted in 18 countries encompassing North America, Latin America, Europe, Middle East/Eurasia, and East Asia. Children and adolescents with atopic dermatitis and their parents and caregivers were identified by the International Study of Asthma and Allergies in Childhood criteria and ever being told by a physician that they had "eczema". Atopic dermatitis severity was assessed using the Patient-Oriented Eczema Measure and the Patient Global Assessment. Atopic dermatitis impact on families' lives was evaluated using the Dermatitis Family Impact questionnaire and stand-alone questions on hours of atopic dermatitis-related care (past week) and missed work days (past 4 weeks) owing to their child's atopic dermatitis. RESULTS: A total of 7465 pairs of pediatric participants with atopic dermatitis and their parents or caregivers were surveyed. Across age groups, the Dermatitis Family Impact questionnaire total score for all regions ranged from 7.1 to 8.6, 13.2 to 14.9, and 17.0 to 17.2 for Patient-Oriented Eczema Measure mild, moderate, and severe atopic dermatitis, respectively. Subscale scores showed that greater atopic dermatitis severity had a greater impact on all family life domains, including sleep and tiredness. No specific patterns or trends were observed across age groups. Time spent on childcare and missed work days increased with atopic dermatitis severity. CONCLUSIONS: Across pediatric age groups and geographic regions, greater atopic dermatitis severity was associated with a greater negative impact on physical, emotional, social, and economic components of family life.

Assessment and Monitoring Challenges Among Patients With Moderate-to-Severe Atopic Dermatitis Across Fitzpatrick Skin Types: A Photographic Review and Case Series.

ABSTRACT: Atopic dermatitis (AD) is a common, chronic, inflammatory skin condition that affects people of all ages, races, and ethnicities. The condition is heterogeneous in both clinical presentation (phenotype) and underlying pathobiology (endotype). Atopic dermatitis diagnosis, assessment, and monitoring rely on clinical evaluation because there are no definitive biomarkers for AD. This review addresses variation in the clinical presentation of AD across the spectrum of Fitzpatrick skin types, with an emphasis on clinical evaluation challenges in patients with skin of color. We present photographs from phase 3 clinical trials that evaluated the safety and efficacy of upadacitinib among patients with moderate-to-severe AD and demonstrate the challenges in evaluating the clinical signs of AD (erythema and excoriation in patients with dark skin types and lichenification in those with light skin types) by illustrating the changes in clinical signs and symptoms that can be achieved with targeted systemic therapies.