Jonathan I Silverberg1, Joel M Gelfand2, David J Margolis2, Mark Boguniewicz3, Luz Fonacier4, Mitchell H Grayson5, Zelma C Chiesa Fuxench6, Eric L Simpson7, Peck Y Ong8. 1. Departments of Dermatology, Preventive Medicine and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Ill. Electronic address: JonathanISilverberg@gmail.com. 2. Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa; Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa. 3. Division of Pediatric Allergy and Clinical Immunology, Department of Pediatrics, National Jewish Health and University of Colorado School of Medicine, Denver, Colo. 4. Department of Medicine, NYU Winthrop Hospital, Mineola, NY. 5. Division of Allergy and Immunology, Nationwide Children's Hospital - The Ohio State University College of Medicine, Columbus, Ohio. 6. Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa. 7. Department of Dermatology, Oregon Health & Science University, Portland, Ore. 8. Clinical Immunology and Allergy, Children's Hospital Los Angeles, University of Southern California, Keck School of Medicine, Los Angeles, Calif.
Abstract
BACKGROUND: Atopic dermatitis (AD) is associated with skin pain. However, little is known about the prevalence and associations of pain in AD. OBJECTIVE: To characterize the frequency, intensity, characteristics, and associations of pain from AD. METHODS: A cross-sectional, US population internet survey-based study of 602 adults with AD from the AD in America Study was performed (modified UK Working Party Criteria). RESULTS: Overall, 365 (61%) reported pain from AD, with 199 (33%) experiencing pain at least once per week and 30 (5%) with pain daily. Among those with AD pain, 22% reported worst pain intensity ≥7. The frequency and intensity of AD pain were associated with Patient-Oriented Scoring Atopic Dermatitis (PO-SCORAD), PO-SCORAD itch and sleep, and Patient-Oriented Eczema Measure (P ≤ .004 for all). Among those experiencing AD pain, 179 (48%) reported pain occurring only after frequent scratching, 156 (42%) reported intermittent pain, and 27 (11%) reported constant pain throughout the day. AD pain was most commonly associated with open areas caused by scratching (27%) and fissures in the skin (27%), followed by inflamed red skin (25%), with only a minority reporting pain mostly caused by burning from creams or ointments (10%). Mild AD was associated with more pain from scratching, whereas severe AD was associated with more constant pain and pain from inflamed skin. CONCLUSIONS: Pain is a distinct symptom in AD, with heterogeneous frequency, characteristics, intensity, and quality of life impact. Pain was related to scratching, fissures, and/or inflamed red skin, and least from burning from topical medications. Skin pain should be assessed in patients with AD and monitoring treatment response.
BACKGROUND:Atopic dermatitis (AD) is associated with skin pain. However, little is known about the prevalence and associations of pain in AD. OBJECTIVE: To characterize the frequency, intensity, characteristics, and associations of pain from AD. METHODS: A cross-sectional, US population internet survey-based study of 602 adults with AD from the AD in America Study was performed (modified UK Working Party Criteria). RESULTS: Overall, 365 (61%) reported pain from AD, with 199 (33%) experiencing pain at least once per week and 30 (5%) with pain daily. Among those with AD pain, 22% reported worst pain intensity ≥7. The frequency and intensity of AD pain were associated with Patient-Oriented Scoring Atopic Dermatitis (PO-SCORAD), PO-SCORAD itch and sleep, and Patient-Oriented Eczema Measure (P ≤ .004 for all). Among those experiencing AD pain, 179 (48%) reported pain occurring only after frequent scratching, 156 (42%) reported intermittent pain, and 27 (11%) reported constant pain throughout the day. AD pain was most commonly associated with open areas caused by scratching (27%) and fissures in the skin (27%), followed by inflamed red skin (25%), with only a minority reporting pain mostly caused by burning from creams or ointments (10%). Mild AD was associated with more pain from scratching, whereas severe AD was associated with more constant pain and pain from inflamed skin. CONCLUSIONS:Pain is a distinct symptom in AD, with heterogeneous frequency, characteristics, intensity, and quality of life impact. Pain was related to scratching, fissures, and/or inflamed red skin, and least from burning from topical medications. Skin pain should be assessed in patients with AD and monitoring treatment response.
Authors: Eric L Simpson; Jonathan I Silverberg; Audrey Nosbaum; Kevin L Winthrop; Emma Guttman-Yassky; Karin M Hoffmeister; Alexander Egeberg; Hernan Valdez; Min Zhang; Saleem A Farooqui; William Romero; Andrew J Thorpe; Ricardo Rojo; Susan Johnson Journal: Am J Clin Dermatol Date: 2021-08-18 Impact factor: 6.233
Authors: Marissa T Ayasse; Adnan Ahmed; Maria L Espinosa; Christina J Walker; Muhammad Yousaf; Jacob P Thyssen; Jonathan I Silverberg Journal: Arch Dermatol Res Date: 2020-11-22 Impact factor: 3.017
Authors: Jonathan I Silverberg; Eric L Simpson; Jacob P Thyssen; Melinda Gooderham; Gary Chan; Claire Feeney; Pinaki Biswas; Hernan Valdez; Marco DiBonaventura; Chudy Nduaka; Ricardo Rojo Journal: JAMA Dermatol Date: 2020-08-01 Impact factor: 10.282
Authors: Kristian Reich; Kenji Kabashima; Ketty Peris; Jonathan I Silverberg; Lawrence F Eichenfield; Thomas Bieber; Aleksandra Kaszuba; Jill Kolodsick; Fan E Yang; Margaret Gamalo; Dennis R Brinker; Amy M DeLozier; Jonathan M Janes; Fabio P Nunes; Jacob P Thyssen; Eric L Simpson Journal: JAMA Dermatol Date: 2020-12-01 Impact factor: 10.282