Patients with adult- and late childhood-onset atopic dermatitis report a higher burden of disease severity than patients with early childhood-onset atopic dermatitis.
Sunday, March 4, 2018
South Hall A2 (Convention Center)
Peck Y. Ong, MD FAAAAI, Zelma Chiesa Fuxench, Luz S. Fonacier, MD FAAAAI, Lawrence B. Schwartz, MD PhD FAAAAI, Mitchell H. Grayson, MD FAAAAI, Julie Block, Lynda Mitchell, MA, Joel M Gelfand, Jonathan I. Silverberg, MD, PhD, MPH, David J Margolis, Mark Boguniewicz, MD FAAAAI, Eric L. Simpson, MD, MCR
RATIONALE: The disease severity of early childhood-onset AD (COAD) has been reported to be higher than that of adult-onset AD (AOAD). However, the disease burden of these patients has not been compared. We used a nation-wide, web-based, population survey and patient-reported outcomes (PRO) to address this question.

METHODS: The GfK Knowledge Panel was used. Of the 8,217 adult subjects who completed the interviews, 602 fulfilled a modified UK Diagnostic Criteria: an itchy skin condition in the past year, and at least 3 of the following: onset under 2y, h/o flexural involvement, h/o generally dry skin, and personal h/o asthma or hayfever. Subjects were further divided based on self-reported age of AD onset: <6y (early COAD), 6-17y (late COAD) and ≥18y (AOAD). PRO instruments included Patient Oriented Eczema Measure (POEM), Patient Oriented-Scoring Atopic Dermatitis (PO-SCORAD), Dermatology Life Quality Index (DLQI) and the Hospital Anxiety and Depression Scale (HADS) scores.

RESULTS: No significant differences in POEM and PO-SCORAD were observed between the 3 groups (mean POEM 7.56, 7.95 and 7, respectively; mean PO-SCORAD 23.83, 28.33 and 25.98, respectively). HADS depression scores were significantly higher in AOAD, as compared to early COAD (5.88 [95%CI 5.45-6.31] vs 4.9 [4.05-5.75])(p<0.05). DLQI scores were significantly higher in the late COAD group compared with early COAD and AOAD (5.33 [3.99-6.66] vs 3.72 [2.53-4.91] and 4.05 [3.51-4.61], respectively)(p<0.05).

CONCLUSIONS: AOAD and late COAD had similar patient reported AD severity, but a higher disease burden compared to early COAD. These results may be confounded due to univariate analysis.