Tamara Salam Housman

Development and validation of a health-related quality of life instrument for women with melasma.

Background  Melasma can have significant emotional and psychological effects on those affected with the condition. In the past, the impact of melasma on health‐related quality of life (HRQoL) has been assessed using general measures of skin disease that equally weigh both the physical and psychosocial distress arising from the presence of a dermatological condition.

Use of the Self-Administered Eczema Area and Severity Index by parent caregivers: results of a validation study.

Summary Background  The Eczema Area and Severity Index (EASI) is used by dermatological investigators world‐wide to assess eczema disease severity. EASI measures are, however, time‐consuming and require trained personnel, thereby limiting its application to large‐scale epidemiological studies. Additionally, the use of self‐assessed severity indices in dermatology is restricted to adult subjects and conditions, thereby not addressing the needs of paediatric patients.

Patients’ Vehicle Preference for Corticosteroid Treatments of Scalp Psoriasis

Topical therapy is one of the foundations of dermatology. The vehicles used to deliver topical therapy have considerable impact on efficacy. The vehicle can have direct effects on disease; it can impact the delivery of the active drug, and its characteristics affect patient compliance. While the physical chemistry of vehicles has been studied in great detail, there has been very little study of patients’ preferences for different vehicles and even less on the effect of these preferences on patient compliance. Such study is essential, as noncompliance with topical therapy is very common, and likely impacts the response to topical therapy observed in clinical practice. This manuscript discusses information on patients’ preferences for different vehicles, focussing on the treatment of scalp psoriasis. Significant vehicle characteristics such as ease or difficulty of use, messiness, odors, and staining are recognized to affect patients’ preferences. An instrument based on these characteristics has been used to compare patients’ preferences for different vehicles. Patients with psoriasis generally prefer less messy vehicles, such as foam and solution preparations, to traditional cream and ointment vehicles. These preferences have the potential to impact patient compliance. Studies directly measuring patient compliance have not yet been performed. In conclusion, the choice of vehicles impacts both the potency of the medication and patients’ acceptance of the treatment. Actual effects of different vehicles on compliance are important but have not yet been adequately studied.

Disease severity and associated family impact in childhood atopic dermatitis

Aim: To examine the association between childhood atopic dermatitis (AD) severity and family impact at baseline and after an intervention by a physician specialist, using validated measures of both severity and family impact. Methods: Cross sectional self administered survey of parent–caregivers of 49 randomly selected children with AD; 35 parents were available for follow up. Family impact was measured using a modified AD Family Impact Scale completed by the parent–caregiver. The child’s disease severity was measured using both the investigator’s assessment via the Eczema Area and Severity Index (EASI) and the caregiver’s assessment via the recently validated Self Assessment Eczema Area and Severity Index (SA-EASI). Results: The parent–caregiver’s assessment of severity of the child was the most significant correlate of the family impact of the child’s AD (p = 0.65 at baseline and p = 0.38 at follow up). In multivariate regression models, the parent–caregiver’s estimate of severity remained the single strongest predictor of family impact before and after receipt of dermatologist care, as well as the difference in impact between pre and post-dermatologist care. Conclusions: There is evidence to support the ability of parent–caregivers of children with AD to accurately determine severity of their child’s AD; perceived severity is the driver of the family impact of this condition. Treatment of a child by a physician specialist is associated with reductions in both perceived severity, as well as family impact of this condition.

The family impact of atopic dermatitis in children: The role of the parent caregiver

Abstract: Although some preliminary work exists examining the impact of atopic dermatitis (AD) in children on their families, there is no empirical work examining specific parent caregiver factors that could contribute to the family impact of this condition. We conducted a cross‐sectional, exploratory analysis of how parent caregivers are affected by their childs AD, and how certain parent caregiver characteristics and perceptions affect the family impact of this condition. Parent caregivers of children with AD (n = 49) were administered a survey to collect detailed data on socioeconomic status, health perceptions, and caregiving issues. Family impact of the childs AD was measured using a modified AD Family Impact Scale. Multiple regression analyses revealed that three major factors associated with the parent caregiver were correlated with large increases in the family impact scores: 1) perception that the childs condition is severe (13%, p < 0.01), 2) high use of nonmedical services for childs condition (21%, p < 0.01), and 3) financial concern about the childs condition (18%, p < 0.01). These preliminary data indicate distinct characteristics of the parent caregiver that are associated with higher family impact of AD in children. These parent caregiver factors may be important in identifying suitable audiences and areas for education for optimal management of childrens AD.