Patient education has been regarded as having a key role in the self-management of atopic eczema. However, the relationship between the educational interventions and clinical outcomes including severity of eczema, quality of life, and family impact has not been rigorously examined. The purpose of this longitudinal randomized controlled study was to evaluate the impact of an intensive education program with a focus on dermatology and immunology designed for parents and children diagnosed with atopic eczema. The intention of this study was not to change treatment regimes prescribed by the patient's physician. The Scoring Atopic Dermatitis rating system was used for assessment of disease impact, and the impact on quality of life was quantified by using the Children's Dermatology Life Quality Index, Infants' Dermatology Quality of Life Index, and Dermatitis Family Impact. A total of 61 pediatric patients (0-16 years) diagnosed with atopic eczema from the metropolitan area of Adelaide were randomized to either the control or intervention group. Results of the study showed that the intervention group had a significant improvement in the scoring atopic dermatitis measure when compared to the control group at week 4 and week 12. Quality of life measures did not significantly improve with decreased severity of eczema except in the group of children aged 5-16 years which, despite small numbers, showed a significant improvement in quality of life scores. These findings suggest that education provides an important role in decreasing the severity of eczema.

We evaluated and compared patients' long-term adherence to biological therapies in a real-life clinical setting. Secondary aims included weight changes on biological therapy and reporting adverse effects. This prospective case-note review included 58 patients, undergoing 84 treatment series including etanercept (21), adalimumab (24), infliximab (14) and ustekinumab (25). Patients' adherence was greatest with ustekinumab (being 6.7-fold less likely to withdraw from treatment than etanercept, P = 0.014), while the difference in treatment adherence of adalimumab and infliximab compared to etanercept was not statistically significant. Adalimumab and infliximab were associated with an increase in weight, while ustekinumab was associated with weight loss compared with etanercept (not statistically significant). Long-term patient adherence to biologic therapy in patients with psoriasis is greatest with ustekinumab.

The role of psychological contributions to common dermatological disease is increasingly recognized. It is often a challenge to find suitable psychological services to complement dermatological treatment. This paper describes the development of a psychological treatment service to reduce scratching behaviour found in common pruritic skin conditions. Our Department of Dermatology together with a consultation-liaison psychiatrist designed a four-session outpatient treatment programme incorporating psychiatric assessment, psychoeducation about the itch-scratch cycle, behavioural analysis, habit reversal techniques and between-session tasks for the patient to complete. This programme is actively modified in consultation with patients and their therapists to suit each patient's individual needs. Formal investigation is required to determine if this psychological treatment adds benefit in overall symptom control beyond dermatological treatment alone.

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