A position paper on the management of itch and pain in atopic dermatitis from the International Society of Atopic Dermatitis (ISAD)/Oriented Patient‐Education Network in Dermatology (OPENED) task force

Miséry, Laurent; Fortina, Anna Belloni; Hachem, Maya El; Chernyshov, Pavel V; Kobyletzki, Laura von; Heratizadeh, Annice; Marcoux, Danielle; Aoki, Valéria; Zaniboni, Mariana Colombini; Stalder, J.F.; Eichenfield, Lawrence F.

doi:10.1111/jdv.16916

Cited by 31 publications

(37 citation statements)

References 111 publications

(140 reference statements)

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“…Emollients have not been shown to have any direct action on skin pain but may have a protective effect against the formation of painful lesions by reducing the number of flares [21], whereas TCI may induce pain hypersensitivity resulting in a burning sensation on application [22]. However, many of the treatments for AD which have been shown to have efficacy against itch have been poorly studied for their effect on skin pain [23], and some patients still experience skin pain despite otherwise controlled disease [20]. A recent position paper has proposed a new treatment algorithm for the management of both itch and skin pain in patients with AD, where common analgesics, gabapentinoids, antidepressants, JAK inhibitors, topical phosphodiesterase 4 inhibitors, and l-opioids could be considered to treat skin pain which persists following initial AD treatments [23].…”

Section: Discussionmentioning

confidence: 99%

Baricitinib Rapidly Improves Skin Pain Resulting in Improved Quality of Life for Patients with Atopic Dermatitis: Analyses from BREEZE-AD1, 2, and 7

Thyssen

Buhl

Fernández‐Peñas

et al. 2021

Dermatol Ther (Heidelb)

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Introduction: Skin pain (described as discomfort or soreness) is increasingly recognized as a symptom of atopic dermatitis which impacts patient quality of life. This analysis examined the effect of baricitinib on skin pain in atopic dermatitis in three phase 3 studies (BREEZE-AD1, -AD2, and -AD7). Methods: Patients were randomly assigned 2:1:1:1 to receive once-daily placebo, baricitinib 1 mg, 2 mg, or 4 mg in BREEZE-AD1 (N = 624) and -AD2 (N = 615) and 1:1:1 to receive oncedaily placebo, baricitinib 2 mg, or 4 mg, with topical corticosteroids, in BREEZE-AD7 (N = 329) for 16 weeks. Patients recorded their skin pain severity using the Skin Pain Numerical Rating Scale (NRS) via an electronic daily diary. Data were analyzed by study as least squares mean change from baseline in daily scores for the randomly assigned patients using mixed model repeated measures analysis. Analysis of

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Section: Discussionmentioning

confidence: 99%

Baricitinib Rapidly Improves Skin Pain Resulting in Improved Quality of Life for Patients with Atopic Dermatitis: Analyses from BREEZE-AD1, 2, and 7

Thyssen

Buhl

Fernández‐Peñas

et al. 2021

Dermatol Ther (Heidelb)

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“…It looks like patients with more severe clinical course of AD more often complain about pain. A recent review on itch and pain in AD contains information that up to 40% of patients with AD report skin pain [ 35 ]. In contrast, the item ‘rejection by other children’ in children with AD and ‘sleep problems’ in SD had a less severe impact than before the pandemic.…”

Section: Discussionmentioning

confidence: 99%

Quality of Life of Infants, Toddlers and Preschoolers with Seborrhoeic, Allergic Contact and Atopic Dermatitis Before and During COVID-19 Pandemic

Chernyshov

Возіанова

Chubar

2021

Dermatol Ther (Heidelb)

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Introduction Different aspects of quality of life (QoL) of infants and children with atopic dermatitis (AD) are well studied but there is a lack of studies on seborrhoeic dermatitis (SD) and allergic contact dermatitis (ACD). The aim of this study was to compare the impact of SD, ACD and AD on young children. Parts of questionnaires were filled in during the COVID-19 pandemic and therefore we decided to check if the pandemic affected dermatology-specific health-related quality of life (HRQoL) in our patients. Methods In this cross-sectional study approved by the local ethics committee of the Kiev City Clinical Dermatovenereologic Hospital parents of children with SD, ACD and AD from birth to 4 years old from the same department of dermatology were asked to fill in the dermatology-specific questionnaire the Infants and Toddlers Dermatology Quality of Life (InToDermQoL). Diagnoses were based on clinical manifestations and anamnesis. The study was carried out from 2018 till 2021. Results The InToDermQoL questionnaire was filled in by 176 parents of children with SD, ACD and AD. Mean total InToDermQoL scores were significantly higher in children with AD than in SD and ACD ( P < 0.01). HRQoL of children with AD during the COVID-19 pandemic was significantly worse than before pandemic (41.30 ± 24.40 and 28.51 ± 17.67 respectively, P = 0.02). Scores of the item on ‘sleep problems’ significantly decreased during the COVID-19 pandemic in children with SD (1.19 ± 1.01 and 0.64 ± 0.63, P < 0.05), as did scores of the item on ‘rejection by other children’ in children with AD (0.96 ± 0.98 and 0.20 ± 0.45, P < 0.05). Conclusions To the best of our knowledge this is the first study on HRQoL of the youngest children with SD and ACD. In our study children with SD and ACD had comparable but lower impact of skin disease on their HRQoL than children with AD. The COVID-19 pandemic led to more severe HRQoL impairment in patients with AD visiting a dermatology department.

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“…Topical therapies for AD include topical corticosteroids (TCSs), calcineurin inhibitors (TCIs), and new topical treatments, such as topical phosphodiesterase 4 (PDE4) inhibitors, novel topical Janus kinase (JAK) inhibitors, tofacitinib and delgocitinib, and UV therapy. Systemic treatments have provided limited evidence regarding pain relief of patients 80 . Most of the treatments present great effects in reducing itch; however, few papers have reported diminishment of pain in AD patients.…”

Section: Management Of Pain In Admentioning

confidence: 99%

“…Calcineurin inhibitors are related to a reduction in pain hypersensitivity 80 . For example, FK506 (tacrolimus) is an immunosuppressant widely used as an ointment in the treatment of AD.…”

Section: Management Of Pain In Admentioning

confidence: 99%

Characteristics, mechanism, and management of pain in atopic dermatitis: A literature review

Dong

2021

Clinical & Translational All

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Background Atopic dermatitis (AD) is a chronic, pruritic, immune‐mediated inflammatory disease. Developments in basic science and clinical research have increased our understanding of AD. Although pain as a symptom of AD is underemphasized in previous studies, multiple researchers address pain as a frequent burden of AD. However, the exact role of pain in AD is not fully understood. Aims Our review aimed to summarize the current evidence focusing on characteristics, mechanism, and management of pain in AD. Materials & Methods We conducted a thorough literature review in the PubMed database to figure out different aspects discussing pain in AD, including pain symptoms, burden, the relationship between pain and itch, mechanism, and pain management in AD. Results and Conclusion AD patients affected by skin pain vary from 42.7%‐92.2% with remarkable intensity and heavy burden. Skin pain and itch interacted both in symptoms and mechanisms. Atopic skin with the impaired barrier, neurogenic inflammation mediators, peripheral and central sensitization of pain may possibly explain pain mechanism in AD. Future research is needed to clarify the commonality and disparity of pain and itch in AD in order to seek efficacious medications and treatment.

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A position paper on the management of itch and pain in atopic dermatitis from the International Society of Atopic Dermatitis (ISAD)/Oriented Patient‐Education Network in Dermatology (OPENED) task force

Cited by 31 publications

References 111 publications

Baricitinib Rapidly Improves Skin Pain Resulting in Improved Quality of Life for Patients with Atopic Dermatitis: Analyses from BREEZE-AD1, 2, and 7

Baricitinib Rapidly Improves Skin Pain Resulting in Improved Quality of Life for Patients with Atopic Dermatitis: Analyses from BREEZE-AD1, 2, and 7

Quality of Life of Infants, Toddlers and Preschoolers with Seborrhoeic, Allergic Contact and Atopic Dermatitis Before and During COVID-19 Pandemic

Characteristics, mechanism, and management of pain in atopic dermatitis: A literature review

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