Burden of skin pain in atopic dermatitis
Burden of skin pain in atopic dermatitis
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DOI：
10.1016/j.anai.2017.09.076
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发表时间：
2017-12-01
影响因子：
5.9
通讯作者：
Silverberg, Jonathan I.
中科院分区：
文献类型：
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作者：
Vakharia, Paras P.;Chopra, Rishi;Silverberg, Jonathan I.
背景：特应性皮炎（AD）与瘙痒、皮肤炎症和屏障破坏以及抓挠有关，所有这些都可能与皮肤疼痛有关。目的：了解阿尔茨海默病患者皮肤疼痛负担的特征。方法：我们进行了一项前瞻性皮肤病学实践为基础的研究，采用问卷调查和皮肤科医生的评估。结果：总体而言，305例患者（年龄范围，13-97岁）被纳入研究，564例就诊。该队列包括195名女性（63.9%）和193名白人（63.7%）。入组时的平均（SD）年龄为42.3（18.1）岁，患者报告的AD发病的平均（SD）年龄为29.6（31.9）岁。在基线时，144名患者（42.7%）报告过去一周的皮肤疼痛，42名患者（13.8%）报告严重或非常严重的疼痛。24人（16.8%）认为皮肤疼痛是瘙痒的一部分，16人（11.2%）认为是抓挠引起的，77人（72.0%）认为两者都有。皮肤疼痛的患者更有可能用类似神经性疼痛的术语来描述他们的瘙痒。皮肤疼痛的患病率在有刮伤的患者中比没有刮伤的患者增加（72.6%比57.6%;chi(2)检验P = 0.02），但其他形态学特征没有增加。皮肤疼痛严重程度最强烈与Patient-Oriented湿疹测量(斯皮尔曼ρ= 0.54),其次是ItchyQOL(ρ= 0.52),瘙痒规模的五维(ρ= 0.47),皮肤病生活质量指数(ρ= 0.45),数字评定量表对瘙痒(ρ= 0.43)和睡眠(ρ= 0.36),病人健康问卷9(ρ= 0.36),patient-reported全球广告严重程度(ρ= 0.34),湿疹面积和严重程度指数(ρ= 0.23),和客观的评分广告指数(ρ= 0.20)(P
Background: Atopic dermatitis (AD) is associated with itch, skin inflammation and barrier disruption, and scratching, all of which may be associated with skin pain.Objective: To characterize the patient burden of skin pain in AD.Methods: We performed a prospective dermatology practice-based study using questionnaires and evaluation by a dermatologist.Results: Overall, 305 patients (age range, 13-97 years) were included in the study, with 564 encounters. The cohort included 195 females (63.9%) and 193 whites (63.7%). The mean (SD) age at enrollment was 42.3 (18.1) years, and the mean (SD) age of patient-reported AD onset was 29.6 (31.9) years. At baseline, 144 patients (42.7%) reported skin pain in the past week, with 42 (13.8%) reporting severe or very severe pain. Twenty-four (16.8%) thought the skin pain was part of their itch, 16 (11.2%) from scratching, and 77 (72.0%) from both. Patients with skin pain were more likely to describe their itch using terms that resembled neuropathic pain. Prevalence of skin pain was increased in patients with vs without excoriations (72.6% vs 57.6%; chi(2) test P =.02) but not other morphologic characteristics. Skin pain severity was most strongly correlated with the Patient-Oriented Eczema Measure (Spearman rho = 0.54), followed by ItchyQOL (rho = 0.52), 5-dimensions of itch scale (rho = 0.47), Dermatology Life Quality Index (rho = 0.45), numeric rating scale for itch (rho = 0.43) and sleep (rho = 0.36), Patient Health Questionnaire 9 (rho = 0.36), patient-reported global AD severity (rho = 0.34), Eczema Area and Severity Index (rho = 0.23), and objective Scoring AD index (rho = 0.20) (P