Atopic Dermatitis in Children in the General Population: Baseline Characteristics, Medication Use, and Severity Measures in the Rotterdam Eczema Study.

IF 4 3区 医学 Q1 DERMATOLOGY
Dermatitis Pub Date : 2024-01-01 Epub Date: 2023-04-04 DOI:10.1089/derm.2022.0040
Karlijn F van Halewijn, Floor van der Most, Arthur M Bohnen, Suzanne G M A Pasmans, Patrick J E Bindels, Gijs Elshout
{"title":"Atopic Dermatitis in Children in the General Population: Baseline Characteristics, Medication Use, and Severity Measures in the Rotterdam Eczema Study.","authors":"Karlijn F van Halewijn, Floor van der Most, Arthur M Bohnen, Suzanne G M A Pasmans, Patrick J E Bindels, Gijs Elshout","doi":"10.1089/derm.2022.0040","DOIUrl":null,"url":null,"abstract":"<p><p><u><b><i>Background:</i></b></u> Real-life data on severity and treatments in children with atopic dermatitis (AD) are needed to evaluate self-management. <u><b><i>Objectives:</i></b></u> To determine severity and use of topical treatments in children with AD in the general population. Furthermore, we aim to determine agreement and correlation between objective and subjective AD severity measures. <u><b><i>Methods:</i></b></u> Data were used from the Rotterdam Eczema Study, an observational prospective cohort study with an embedded pragmatic open-label randomized controlled trial. Descriptive statistics were used for baseline characteristics, medication use, and severity. Strength of agreement and correlation were determined using kappa analysis and Pearson correlation. <u><b><i>Results:</i></b></u> In total, 367 children (mean age 5.7 years) were recruited. The mean eczema area and severity index (EASI) score was 2.1 (±3.2) and mean patient-oriented eczema measure (POEM) score was 10.3 (±6.1). The majority applied emollients on a daily basis (54.9%) and had not used topical corticosteroids (TCSs) over the past week (51%). Based on severity banding of POEM and EASI, 49.9% and 24.9% of the children were undertreated, respectively. No evidence was found for an agreement between EASI and POEM (kappa 0.028, n = 178, <i>P</i> = 0.451). A moderate correlation between POEM, EASI, infants' dermatitis quality of life index, and children's dermatology life quality index was found. POEM showed higher correlation with quality of life (QoL) than EASI. <u><b><i>Conclusion:</i></b></u> Emollients were used sufficiently in the study population. Based on signs or symptoms, 24.9% and 49.9% of children are undertreated, respectively. POEM scores correlated better with QoL than with EASI scores. We argue that EASI underestimates severity of AD, and treatment based on EASI scores may lead to undertreatment of AD. Treating physicians should be aware of suboptimal use of TCSs.</p>","PeriodicalId":11047,"journal":{"name":"Dermatitis","volume":" ","pages":"61-69"},"PeriodicalIF":4.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Dermatitis","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/derm.2022.0040","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/4/4 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"DERMATOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Real-life data on severity and treatments in children with atopic dermatitis (AD) are needed to evaluate self-management. Objectives: To determine severity and use of topical treatments in children with AD in the general population. Furthermore, we aim to determine agreement and correlation between objective and subjective AD severity measures. Methods: Data were used from the Rotterdam Eczema Study, an observational prospective cohort study with an embedded pragmatic open-label randomized controlled trial. Descriptive statistics were used for baseline characteristics, medication use, and severity. Strength of agreement and correlation were determined using kappa analysis and Pearson correlation. Results: In total, 367 children (mean age 5.7 years) were recruited. The mean eczema area and severity index (EASI) score was 2.1 (±3.2) and mean patient-oriented eczema measure (POEM) score was 10.3 (±6.1). The majority applied emollients on a daily basis (54.9%) and had not used topical corticosteroids (TCSs) over the past week (51%). Based on severity banding of POEM and EASI, 49.9% and 24.9% of the children were undertreated, respectively. No evidence was found for an agreement between EASI and POEM (kappa 0.028, n = 178, P = 0.451). A moderate correlation between POEM, EASI, infants' dermatitis quality of life index, and children's dermatology life quality index was found. POEM showed higher correlation with quality of life (QoL) than EASI. Conclusion: Emollients were used sufficiently in the study population. Based on signs or symptoms, 24.9% and 49.9% of children are undertreated, respectively. POEM scores correlated better with QoL than with EASI scores. We argue that EASI underestimates severity of AD, and treatment based on EASI scores may lead to undertreatment of AD. Treating physicians should be aware of suboptimal use of TCSs.

普通人群中的儿童特应性皮炎:鹿特丹湿疹研究》中的基线特征、药物使用和严重程度测量。
背景:需要有关特应性皮炎(AD)儿童严重程度和治疗方法的真实数据,以评估自我管理情况。目标: 确定一般特应性皮炎儿童的严重程度和外用治疗方法的使用情况:确定普通人群中儿童特应性皮炎的严重程度和局部治疗的使用情况。此外,我们还旨在确定客观和主观特应性皮炎严重程度测量之间的一致性和相关性。研究方法数据来自鹿特丹湿疹研究(Rotterdam Eczema Study),这是一项观察性前瞻性队列研究,其中包含一项实用开放标签随机对照试验。对基线特征、药物使用和严重程度进行了描述性统计。使用卡帕分析和皮尔逊相关性确定一致性和相关性的强度。结果:共招募了 367 名儿童(平均年龄 5.7 岁)。湿疹面积和严重程度指数(EASI)平均得分为 2.1 (±3.2),以患者为导向的湿疹测量(POEM)平均得分为 10.3 (±6.1)。大多数患者每天使用润肤剂(54.9%),过去一周未使用外用皮质类固醇激素(TCS)(51%)。根据 POEM 和 EASI 的严重程度分级,分别有 49.9% 和 24.9% 的儿童治疗不足。没有证据表明 EASI 与 POEM 之间存在一致性(kappa 0.028,n = 178,P = 0.451)。POEM、EASI、婴儿皮炎生活质量指数和儿童皮肤病生活质量指数之间存在中度相关性。POEM 与生活质量 (QoL) 的相关性高于 EASI。结论研究对象充分使用了润肤剂。根据体征或症状,分别有 24.9% 和 49.9% 的儿童治疗不足。POEM 评分与 QoL 的相关性优于 EASI 评分。我们认为,EASI 低估了 AD 的严重程度,根据 EASI 分数进行治疗可能会导致 AD 治疗不足。负责治疗的医生应该意识到TCS的次优使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Dermatitis
Dermatitis 医学-皮肤病学
CiteScore
5.30
自引率
11.50%
发文量
251
审稿时长
>12 weeks
期刊介绍: Dermatitis is owned by the American Contact Dermatitis Society and is the home journal of 4 other organizations, namely Societa Italiana di Dermatologica Allergologica Professionale e Ambientale, Experimental Contact Dermatitis Research Group, International Contact Dermatitis Research Group, and North American Contact Dermatitis Group. Dermatitis focuses on contact, atopic, occupational, and drug dermatitis, and welcomes manuscript submissions in these fields, with emphasis on reviews, studies, reports, and letters. Annual sections include Contact Allergen of the Year and Contact Allergen Alternatives, for which papers are chosen or invited by the respective section editor. Other sections unique to the journal are Pearls & Zebras, Product Allergen Watch, and news, features, or meeting abstracts from participating organizations.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信