Pain Is a Common and Burdensome Symptom of Atopic Dermatitis in United States Adults.

Abstract

BACKGROUND:

Atopic dermatitis (AD) is associated with skin pain. However, little is known about the prevalence and associations of pain in AD.

OBJECTIVE:

To characterize the frequency, intensity, characteristics, and associations of pain from AD.

METHODS:

A cross-sectional, US population internet survey-based study of 602 adults with AD from the AD in America Study was performed (modified UK Working Party Criteria).

RESULTS:

Overall, 365 (61%) reported pain from AD, with 199 (33%) experiencing pain at least once per week and 30 (5%) with pain daily. Among those with AD pain, 22% reported worst pain intensity ≥7. The frequency and intensity of AD pain were associated with Patient-Oriented Scoring Atopic Dermatitis (PO-SCORAD), PO-SCORAD itch and sleep, and Patient-Oriented Eczema Measure (P ≤ .004 for all). Among those experiencing AD pain, 179 (48%) reported pain occurring only after frequent scratching, 156 (42%) reported intermittent pain, and 27 (11%) reported constant pain throughout the day. AD pain was most commonly associated with open areas caused by scratching (27%) and fissures in the skin (27%), followed by inflamed red skin (25%), with only a minority reporting pain mostly caused by burning from creams or ointments (10%). Mild AD was associated with more pain from scratching, whereas severe AD was associated with more constant pain and pain from inflamed skin.

CONCLUSIONS:

Pain is a distinct symptom in AD, with heterogeneous frequency, characteristics, intensity, and quality of life impact. Pain was related to scratching, fissures, and/or inflamed red skin, and least from burning from topical medications. Skin pain should be assessed in patients with AD and monitoring treatment response.

• Authors: Jonathan I Silverberg, Joel M Gelfand, David J Margolis, Mark Boguniewicz, Luz Fonacier, Mitchell H Grayson, Zelma C Chiesa Fuxench, Eric L Simpson, Peck Y Ong
• Journal: The journal of allergy and clinical immunology. In practice (J Allergy Clin Immunol Pract) 2019 Nov - Dec Vol. 7 Issue 8 Pg. 2699-2706.e7 ISSN: 2213-2201 [Electronic] United States
• PMID: 31228619 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2019 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Dermatitis, Atopic (complications, epidemiology)
• Female
• Humans
• Male
• Middle Aged
• Pain (epidemiology, etiology)
• Prevalence
• Pruritus (epidemiology, etiology)
• Quality of Life
• Skin
• United States (epidemiology)