Characterization and Burden of Pain in Atopic Dermatitis: A Pilot Study
Sunday, March 4, 2018
South Hall A2 (Convention Center)
Sunada Mattancheril, Miranda Schmidt, Frank Penedo, Amy S Paller, Anna B. Fishbein, MD

Atopic dermatitis (AD) is common, with 60-80% of children suffering from associated pain. Yet, the burden of pain has not been characterized.


Descriptive study about quality of life in children ages 5-17 years with AD, controlled asthma/allergic rhinitis (n=27). Pain interference and pain intensity (Likert scale 0-10) were assessed via NIH PROMIS Profile-37, with scores compared to population norms. Children ≥8y self-reported, with parent proxy <8y. Disease severity was assessed via clinician ((Scoring atopic dermatitis (SCORAD), Eczema Area and Severity Index (EASI)) and patient/parent (Patient Oriented Eczema Measure (POEM)).


Children with AD (54% male & 11.4y±4.0 (mean±SD)) were recruited. Participants were 29% mild, 36% moderate, or 32% severe on POEM. Pain was reported in 70% of participants, with an average intensity of 3.3±2.3. Of objective disease severity measures, presence of skin oozing/crusting was the only finding associated with pain (χ2 =11.2, p=0.03). Children’s Dermatology Life Quality Index correlated with pain intensity (r=0.58, p<0.01), but itch and clinician-reported disease severity did not (Itch Visual Analog Scale, r=0.25, p=0.21; SCORAD, r=0.33,p=0.11 and EASI, r=0.25,p=0.24). Pain interference mean T score was 47.4±10.5. Only three participants had a pain interference T-score >1 SD from the mean; all had severe AD.


In our cohort, pain affected most children with AD. Oozing/crusting was the most significant objective finding in children with pain. However the burden of pain (pain interference with daily life) was greater than the general population only in 11% of children with AD. These findings are being tested in a larger population.