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Quality of Life and Characterization of Patients With Atopic Dermatitis in Portugal: The QUADEP Study

Carvalho D1, Aguiar P1, Mendes-Bastos P2, Palma-Carlos A3, Freitas J4, Ferrinho P5

1NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisboa, Portugal
2Dermatology Centre, Hospital CUF Descobertas, Lisboa, Portugal
3CAIC – Clinica de Alergia e Imunologia Clinicas, Lisboa, Portugal
4Blueclinical, Senhora da Hora, Portugal
5GHTM, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal

J Investig Allergol Clin Immunol 2020; Vol 30(6) : 430-438
doi: 10.18176/jiaci.0443

Objectives: To investigate the quality of life (QOL) of and to characterize patients with atopic dermatitis (AD) in Portugal.
Methods: This was a cross-sectional study of patients with AD and other eczemas. Skindex-29, Skindex-teen, and the Childhood Atopic Dermatitis Impact Scale (CADIS) were the instruments used to assess QOL in adults, teenagers, and children, respectively. The SF-12 was also used, and disease severity was evaluated using the Patient-Oriented SCORAD (PO-SCORAD) instrument. Associations with QOL were assessed based on the odds ratio (OR). P values <.05 and 95%CIs were considered statistically significant.
Results: The study population comprised 162 participants aged 0.5-74 years. We found that 37.3% of AD patients consider their disease disabling and that more than half of the patients feel stigmatized by society. The mean Skindex score for AD was 39.68, and the impact on QOL was severe in 44%. “Symptoms” was the most affected category in adults. AD was moderate to severe in 87% of the sample. One of the factors that most influenced poorer QOL in AD was age: with increasing age, the Skindex is likely to increase (OR, 1.03; 95%CI, 1.00-1.06). “Considering the disease a disability” was also associated (OR, 6.72; 95%CI, 2.56-17.63). QOL worsens with increasingly affected body area (OR, 1.07; 95%CI, 1.03-1.11) and the presence of edema (OR, 2.0; 95%CI, 1.23-3.40).
Conclusions: This is the first study to provide data on QOL in patients with AD in Portugal. Our data show an expected negative impact. More awareness-raising activities are needed to increase knowledge, decrease stigmatization, and, consequently, address the factors involved in the QOL of patients with AD.

Key words: Atopic dermatitis, Atopic eczema, Portugal, Quality of life, Skindex