Skin pain is a common and burdensome symptom in AD. Skin pain severity should be assessed with itch severity in AD patients and may be an important end point for monitoring treatment response.

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This study suggests that SD and SRI are common in adults with AD, particularly those with severe diseases. Sleep disturbances and SRI should be considered when assessing burden of AD and therapeutic decisions.

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Patients with alopecia areata have multiple risk factors for mental health disorders, including psychological distress and impaired quality of life. Alopecia areata was associated with increased mental health disorders and hospitalization primarily for a mental health disorders. Alopecia areata patients require close monitoring for mental health disorders.

Background Multiple strategies have been used to evaluate the minimal important change (MIC) of the Eczema Area and Severity Index (EASI) and Scoring Atopic Dermatitis (SCORAD). The meaningfulness of these MICs is not well established across all severities of atopic dermatitis (AD). Objectives To determine the MIC of percentage and absolute improvement of EASI and SCORAD scores in adults and children with AD. Methods We performed a prospective dermatology practice-based study using questionnaires and evaluation by a dermatologist (n = 826). An anchor-based approach was used to determine thresholds for the percentage and absolute MICs of EASI, SCORAD and objective SCORAD (O-SCORAD) at follow-up from baseline. Results One-grade improvements of Physician's Global Assessment (PGA) and validated Investigator Global Assessment scale for AD (vIGA-AD) were associated with 50%, 35% and 35% decreases of EASI, SCORAD and O-SCORAD, respectively. The thresholds for percentage MIC of EASI (Kruskal-Wallis test, P = 0Á61), SCORAD (P = 0Á07) and O-SCORAD (P = 0Á09) were similar across baseline AD severities. One-grade improvements of PGA and vIGA-AD were associated with 14Á0-and 14Á9point decreases of EASI, 19Á9-and 14Á9-point decreases of SCORAD, and 15Á5-and 17Á4-point decreases of O-SCORAD. The thresholds for the absolute MIC of EASI (P < 0Á001), SCORAD (P < 0Á001) and O-SCORAD (P < 0Á001) significantly differed by baseline AD severity. Percentage and absolute MICs for EASI and SCORAD were associated with improvements of AD symptoms and quality of life. Conclusions EASI 50, SCORAD 35 and O-SCORAD 35 were meaningful percentage MICs regardless of baseline AD severity. The absolute MICs for EASI, SCORAD and O-SCORAD varied by baseline AD severity.What is already known about this topic?• Most existing clinician-reported outcomes for atopic dermatitis severity are not feasible or valid for use in clinical practice.

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