特应性皮炎的习惯性抓挠及其与疾病严重程度的关系:来自日本健康保险索赔和基于应用程序的数据的发现

IF 4.2 3区 医学 Q1 DERMATOLOGY
Takeshi Nakahara, Shinichi Noto, Miyuki Matsukawa, Yasuhito Konishi, Rikiya Toda, Daisaku Michikami, Hiroyuki Murota
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引用次数: 0

摘要

在特应性皮炎(AD)中,抓挠维持炎症并损害皮肤屏障。除了瘙痒引起的抓挠,受影响的个体可能会习惯性抓挠,定义为重复的、无意识的抓挠,但没有瘙痒。日本患者习惯性抓挠的程度和临床意义尚不清楚。本研究旨在评估日本人群中习惯性抓挠的频率及其与AD严重程度的关系。方法:这项横断面研究是在日本进行的,使用匿名健康保险索赔数据和2022年10月实施的全国性应用程序问卷。纳入的个体包括成人(19-74岁)和儿童(年龄≤18岁),他们自我报告诊断为AD,并且在过去6个月内出现症状或接受治疗。习惯性抓挠用两个是/否问题来评估。使用患者导向湿疹量表(POEM)测量疾病严重程度,并使用Cochran-Armitage趋势检验检验相关性。结果:共纳入成人1507人,儿童525人。在成年人中,44.5%的人表示抓挠时不觉得痒,30.0%的人表示只有在别人指出抓挠时才会注意到;在儿童中,这两个比例分别为57.5%和53.3%。表现出这两种行为的患者比例随着POEM严重程度的增加而显著增加。对于无瘙痒的抓挠,成人的发生率从35.1%到62.9%,儿童的发生率从44.5%到82.6% (p结论:在日本,所有AD严重程度的患者都普遍报告了习惯性抓挠,并且与更严重的疾病严重程度相关。这些发现强调了识别/注意和积极管理无意识抓挠行为作为AD综合护理的一部分的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Habitual Scratching in Atopic Dermatitis and Its Association with Disease Severity: Findings from Japanese Health Insurance Claims and App-Based Data.

Introduction: In atopic dermatitis (AD), scratching sustains inflammation and impairs the skin barrier. Beyond scratching driven by itch, affected individuals may engage in habitual scratching, defined as repetitive, unconscious scratching that occurs without itch. The extent and clinical significance of habitual scratching in Japanese patients remain unclear. This study aimed to assess the frequency of habitual scratching and its association with AD severity in the Japanese population.

Methods: This cross-sectional study was conducted in Japan using data from anonymized health insurance claims and a nationwide app-based questionnaire administered in October 2022. Included individuals were adults (aged 19-74 years) and children (aged ≤ 18 years) with a self-reported diagnosis of AD and either symptoms or treatment within the previous 6 months. Habitual scratching was assessed using two yes/no questions. Disease severity was measured using the Patient-Oriented Eczema Measure (POEM), and associations were tested using the Cochran-Armitage trend test.

Results: A total of 1507 adults and 525 children were included. Among adults, 44.5% reported scratching without feeling itchy, and 30.0% reported only noticing scratching when it was pointed out; among children, these proportions were 57.5% and 53.3%, respectively. The proportion of patients exhibiting both behaviors increased significantly with POEM severity. For scratching without itch, rates ranged from 35.1% to 62.9% in adults and from 44.5% to 82.6% in children (p < 0.001 for both). For unnoticed scratching, rates ranged from 19.0% to 50.3% in adults and from 41.2% to 69.6% in children (p < 0.001 for both).

Conclusions: Habitual scratching was commonly reported across all severity levels of AD in Japan and was associated with greater disease severity. These findings highlight the importance of recognizing/noticing and actively managing unconscious scratching behaviors as part of comprehensive AD care.

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来源期刊
Dermatology and Therapy
Dermatology and Therapy Medicine-Dermatology
CiteScore
6.00
自引率
8.80%
发文量
187
审稿时长
6 weeks
期刊介绍: Dermatology and Therapy is an international, open access, peer-reviewed, rapid publication journal (peer review in 2 weeks, published 3–4 weeks from acceptance). The journal is dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of dermatological therapies. Studies relating to diagnosis, pharmacoeconomics, public health and epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to all clinical aspects of dermatology, such as skin pharmacology; skin development and aging; prevention, diagnosis, and management of skin disorders and melanomas; research into dermal structures and pathology; and all areas of aesthetic dermatology, including skin maintenance, dermatological surgery, and lasers. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/case series, trial protocols, and short communications. Dermatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an International and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. The journal appeals to a global audience and receives submissions from all over the world.
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