Section : Conference Notes

Defining (D) Atopic Dermatitis (AD) And Measuring Its Impact (I) (For Professionals)

Defining (D) Atopic Dermatis (AD) And Measuring Its Impact (I) (For Professionals)

D

Is termed eczema which to divide in atopic and non atopic.

The other type is contact dermatitis (allergic or non allergic). 2004

What is a good definition ?:

  • It is valid
  • It is repeatable
  • It is accepted by others
  • It is easy to define
  • It makes sense (coherence)

Many different tools have been used to define atopic dermatitis (AD):

  • The Most famous: Hanifin et Rajka (H & R)
  1. 3 major elements: pruritus, lichenification, chronic relapsing course, personal family history
  2. 3 minor elements: dry skin, ichtyosis…..over 20 elements
  • Then: UK refinement of H & R criteria
  1. Itch
  2. plus 3 or more of:
  1. flexural involvement
  2. family history of flexural involvement
  3. history of dry skin
  4. beginning before 2 years of age (not valid if beginning after 4 years of age)
  • many other tools exist: millenium criteria (IgE), danish….to conclude a widely accepted common diagnostic tool is lacking and until this happens, it will be difficult to compare studies and measure them according to one’s own practice.

B

  • Frequency of AD
  1. More frequent in affluent countries: more than 15% of the childhood population in the UK, Finland, Sweden. More than 10% of the childhood population in New Zealand and Central Europe.
  2. Quite interestingly though there has been a strong increase in SE Asia (where the prevalence was low) and generally in urban areas.
  3. Concerning Adult AD: its prevalence among the population is about 10% in Europe and other countries such as Thailand
  • AD has a poor prognosis and risks continuing in adulthood:
  1. if early onset
  2. if severe in signs and symptoms…
  3. Overall 40%-60% of childhood AD persists into adulthood
  4. Of those having had childhood AD,  1/4 keep to have hand eczema as adults
  • Costs of AD
  1. In European countries, the brunt of the cost is carried by families (465 million pounds each year in the UK) rather than the social welfare system
  • Quality of life (QoL) impairement:
  1. increased anxiety among patients with atopic dermatitis
  2. increased stress among patients with atopic dermatitis
  3. higher prevalence of depression among patients with atopic dermatitis
  4. avoidance of certain jobs: 40% of patients with AD do so.

Contributors:

Dr Christophe HSU – dermatologist. Geneva, Switzerland

Source of information: Flohr C. Definition and burden of AD. 19th Congress of the European Academy of Dermatology and Venereology (EADV) – Gothenburg (Göteborg), Sweden (Sverige).


Category : adultes - Modifie le 10.10.2010Category : adults - Modifie le 10.10.2010Category : atopic dermatitis - Modifie le 10.10.2010Category : burden - Modifie le 10.10.2010Category : définition - Modifie le 10.10.2010Category : dermatite atopique - Modifie le 10.10.2010Category : poids émotionnel - Modifie le 10.10.2010