Supriya Immaneni

Assessment of atopic dermatitis using self-report and caregiver report: a multicentre validation study

The epidemiology of atopic dermatitis (AD) in the U.S.A. has been described largely via US population‐based questionnaire studies. However, the validity of the questions used for self‐ and caregiver‐reported eczema has not been previously demonstrated.

Severity strata for Eczema Area and Severity Index (EASI), modified EASI, Scoring Atopic Dermatitis (SCORAD), objective SCORAD, Atopic Dermatitis Severity Index and body surface area in adolescents and adults with atopic dermatitis

Scoring systems for assessing the signs of atopic dermatitis (AD) are complex and difficult to interpret. Severity strata are helpful to interpret these assessments properly.

Burden of skin pain in atopic dermatitis

BACKGROUND Atopic dermatitis (AD) is associated with itch, skin inflammation and barrier disruption, and scratching, all of which may be associated with skin pain. OBJECTIVE To characterize the patient burden of skin pain in AD. METHODS We performed a prospective dermatology practice-based study using questionnaires and evaluation by a dermatologist. RESULTS Overall, 305 patients (age range, 13-97 years) were included in the study, with 564 encounters. The cohort included 195 females (63.9%) and 193 whites (63.7%). The mean (SD) age at enrollment was 42.3 (18.1) years, and the mean (SD) age of patient-reported AD onset was 29.6 (31.9) years. At baseline, 144 patients (42.7%) reported skin pain in the past week, with 42 (13.8%) reporting severe or very severe pain. Twenty-four (16.8%) thought the skin pain was part of their itch, 16 (11.2%) from scratching, and 77 (72.0%) from both. Patients with skin pain were more likely to describe their itch using terms that resembled neuropathic pain. Prevalence of skin pain was increased in patients with vs without excoriations (72.6% vs 57.6%; χ2 test P = .02) but not other morphologic characteristics. Skin pain severity was most strongly correlated with the Patient-Oriented Eczema Measure (Spearman ρ = 0.54), followed by ItchyQOL (ρ = 0.52), 5-dimensions of itch scale (ρ = 0.47), Dermatology Life Quality Index (ρ = 0.45), numeric rating scale for itch (ρ = 0.43) and sleep (ρ = 0.36), Patient Health Questionnaire 9 (ρ = 0.36), patient-reported global AD severity (ρ = 0.34), Eczema Area and Severity Index (ρ = 0.23), and objective Scoring AD index (ρ = 0.20) (P < .001 for all). Patients with both severe itch and pain vs those with only one or neither symptom being severe had significant increases in all these measures. CONCLUSION Skin pain is a common and burdensome symptom in AD. Skin pain severity should be assessed with itch severity in AD patients and may be an important end point for monitoring treatment response.

Cost-effectiveness of Prophylactic Moisturization for Atopic Dermatitis.

Importance Emerging evidence suggests that the use of moisturizers on newborns and infants (ie, from birth to 6 months of age) is potentially helpful in preventing the development of atopic dermatitis. Objective To investigate the cost-effectiveness of using a daily moisturizer as prevention against atopic dermatitis among high-risk newborns. Design, Setting, and Participants In a cost-effectiveness analysis, the average cost of total-body moisturization using 7 common moisturizers from birth to 6 months of age was determined for male and female infants. We assumed the same unit of weight per moisturizer used for a given body surface area. Based on previously reported data (relative risk reduction of 50%), the incremental gain in quality-adjusted life-years (QALYs) was determined using a 6-month time window. The cost-effectiveness of each moisturizer was determined by assuming equal efficacy. A sensitivity analysis was conducted by varying the relative risk from 0.28 to 0.90. Interventions Use of prophylactic moisturizing compounds. Main Outcomes and Measures The primary outcomes were the incremental cost-effectiveness values (

Early-onset pediatric atopic dermatitis is characterized by T H 2/T H 17/T H 22-centered inflammation and lipid alterations

/QALY) for each moisturizer in preventing atopic dermatitis during a 6-month time window. Results The calculated amount of daily all-body moisturizer needed at birth was 3.6 g (0.12 oz) per application, which increased to 6.6 g (0.22 oz) at 6 months of age. Of the 7 products evaluated, the average price was

Validation of patient-reported global severity of atopic dermatitis in adults

1.07/oz (range,

Severity strata for five patient-reported outcomes in adults with atopic dermatitis

0.13/oz-

Relationship between EASI and SCORAD severity assessments for atopic dermatitis

2.96/oz). For a 6-month time window, the average incremental QALY benefit was 0.021. The sensitivity analysis showed that the incremental gain of QALY ranged from 0.0041 to 0.030. Petrolatum was the most cost-effective (

Association between atopic dermatitis, depression and suicidal ideation: A systematic review and meta-analysis

353/QALY [95% CI,

Measurement properties of three assessments of burden used in atopic dermatitis in adults

244-