Itching and treatments in atopic dermatitis (AD): results from the German AD registry TREATgermany

Weißhaar, Elke; Bentz, Philipp; Haufe, Eva; Heinrich, Luise; Apfelbacher, Christian; Heratizadeh, Annice; Abraham, Susanne; Harder, Inken; Kleinheinz, Andreas; Wollenberg, Andreas; Schäkel, Knut; Wiemers, Franca; Ertner, Konstantin; Augustin, Matthias; Wildberger, Julia; Kiedrowski, Ralph von; Worm, Margitta; Zink, Alexander; Effendy, Isaak; Asmussen, Andrea; Pawlak, Mario; Sticherling, Michael; Hilgers, M.; Handrick, Christiane; Quist, Sven; Schwarz, Beate; Bell, M.; Staubach‐Renz, Petra; Hong-Weldemann, Su-Hei; Homey, Bernhard; Bruecher, Jens; Weidinger, Stephan; Werfel, Thomas; Schmitt, Jochen

doi:10.1093/bjd/ljac070

Cited by 3 publications

(5 citation statements)

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“…Chronic itch is a disease‐defining AD symptom, contributing to sleep loss in the affected patients 9,54 . Itch (NRS/past three days) was previously reported by 97% of TREATgermany patients at baseline with 45% reporting NRS‐scores equal to or higher than 7 55,56 . The severe itching and sleep loss can lead to a reduced quality of life and lack of physical and mental recovery, which may further provoke depressive symptoms, anxiety, clinical depression, and suicidal thoughts 57–64 .…”

Section: Discussionmentioning

confidence: 99%

“…9,54 Itch (NRS/past three days) was previously reported by 97% of TREATgermany patients at baseline with 45% reporting NRS-scores equal to or higher than 7. 55,56 The severe itching and sleep loss can lead to a reduced quality of life and lack of physical and mental recovery, which may further provoke depressive symptoms, anxiety, clinical depression, and suicidal thoughts. [57][58][59][60][61][62][63][64] In particular, the interaction of these symptoms may lead to a further exacerbation.…”

Section: Discussionmentioning

confidence: 99%

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Itch, sleep loss, depressive symptoms, fatigue, and productivity loss in patients with moderate‐to‐severe atopic dermatitis: Analyses of TREATgermany registry data

Birkner

Siegels

Heinrich

et al. 2023

J Deutsche Derma Gesell

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SummaryBackgroundTREATgermany is a multicenter registry including patients with moderate‐to‐severe atopic dermatitis (AD) from currently 74 study centers (university clinics, hospitals and practices) in Germany. As of August 31, 2021, 1,230 adult patients were enrolled.MethodsIn TREATgermany, patients and physicians fill in questionnaires pertaining to symptoms, disease severity, quality of life, depressiveness, and fatigue. In particular, limitations in work performance are assessed using the Work Limitations Questionnaire (WLQ). To assess associations between occupational performance/work limitations and symptoms, correlations and regression models were calculated.ResultsThe examined sample of 228 employed patients reported an average of 6% at‐work productivity loss within the past two weeks prior to enrolment in the registry. The WLQ productivity loss score was moderately associated with itch (r = 0.32) and sleep loss (r = 0.39) and strongly associated with depressive symptoms (r = 0.68) and fatigue (r = 0.60).ConclusionsThe analyses of the registry data show that moderate‐to‐severe atopic dermatitis has a negative impact on the work productivity of the patients. The analyses further point out the relevant associations between work productivity, depressive symptoms, and fatigue highlighting the disease burden caused by the psychological components of AD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Itch, sleep loss, depressive symptoms, fatigue, and productivity loss in patients with moderate‐to‐severe atopic dermatitis: Analyses of TREATgermany registry data

Birkner

Siegels

Heinrich

et al. 2023

J Deutsche Derma Gesell

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“…9,54 Juckreiz (NRS/letzte drei Tage) wurde zuvor von 97% der TREATgermany-Patienten bei der Erstuntersuchung angegeben, wobei 45% NRS-Werte von 7 oder höher berichteten. 55,56 Der starke Juckreiz und die Schlafstörungen können zu einer eingeschränkten Lebensqualität und mangelnder körperlicher und geistiger Erholung führen, was wiederum depressive Symptome, Angstzustände, klinische Depressionen und Suizidgedanken hervorrufen kann. [57][58][59][60][61][62][63][64] Insbesondere das Zusammenspiel dieser Symptome kann zu einer weiteren Verschlimmerung führen.…”

Section: N (%) N (%) N (%)unclassified

“…Chronischer Juckreiz ist ein krankheitsbestimmendes AD‐Symptom, das bei den betroffenen Patienten zu Schlafstörungen führt 9,54 . Juckreiz (NRS/letzte drei Tage) wurde zuvor von 97% der TREATgermany‐Patienten bei der Erstuntersuchung angegeben, wobei 45% NRS‐Werte von 7 oder höher berichteten 55,56 . Der starke Juckreiz und die Schlafstörungen können zu einer eingeschränkten Lebensqualität und mangelnder körperlicher und geistiger Erholung führen, was wiederum depressive Symptome, Angstzustände, klinische Depressionen und Suizidgedanken hervorrufen kann 57–64 .…”

Section: Diskussionunclassified

Juckreiz, Schlafstörungen, depressive Symptome, Fatigue und Einschränkungen der Arbeitsproduktivität bei Patienten mit moderater bis schwerer atopischer Dermatitis: Daten aus dem TREATgermany‐Register

Birkner,

Siegels,

Heinrich

et al. 2023

J Deutsche Derma Gesell

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ZusammenfassungHintergrundTREATgermany ist ein multizentrisches Register, das Patienten mit moderater bis schwerer atopischer Dermatitis (AD) aus derzeit 74 Studienzentren (Universitätskliniken, Krankenhäuser und Praxen) in Deutschland umfasst. Bis zum 31. August 2021 wurden 1.230 erwachsene Patienten eingeschlossen.MethodenIn TREATgermany füllen Patienten und Ärzte Fragebögen zu Symptomen, Krankheitsschwere, Lebensqualität, Depressivität und Fatigue aus. Die Einschränkungen der Arbeitsleistung werden insbesondere mit dem Work Limitations Questionnaire (WLQ) erfasst. Um Assoziationen zwischen beruflicher Leistung/Arbeitseinschränkungen und Symptomen zu bestimmen, wurden Korrelationen und Regressionsmodelle berechnet.ErgebnisseDie untersuchte Stichprobe von 228 berufstätigen Patienten beschrieb einen durchschnittlichen Produktivitätsverlust von 6% bei der Arbeit innerhalb der letzten zwei Wochen vor der Aufnahme in das Register. Der WLQ‐Wert für den Produktivitätsverlust war moderat mit Juckreiz (r = 0,32) und Schlafstörungen (r = 0,39) und stark mit depressiven Symptomen (r = 0,68) und Fatigue (r = 0,60) korreliert.SchlussfolgerungenDie Analysen der Registerdaten zeigen, dass eine moderate bis schwere AD einen negativen Einfluss auf die Arbeitsproduktivität der Patienten hat. Die Analysen weisen außerdem auf die relevanten Zusammenhänge zwischen Arbeitsproduktivität, depressiven Symptomen und Fatigue hin, was die durch die psychologischen Komponenten der AD verursachte Krankheitslast verdeutlicht.

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“…Typical pruritic inflammatory skin disorders such as atopic dermatitis and contact dermatitis illustrate the consequences of persistent scratching. It has been convincingly shown that minimizing scratching alleviates the inflammatory response, potentially offering therapeutic benefits [7]. Additionally, such physical disruptions might also modify the skin microbiota, which is essential for maintaining skin health [8].…”

Section: Introductionmentioning

confidence: 99%

Effects of Superficial Scratching and Engineered Nanomaterials on Skin Gene Profiles and Microbiota in SKH-1 Mice

Mäenpää,

Ilves,

Zhao

et al. 2023

IJMS

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Scratching damages upper layers of the skin, breaks this first line of immune defence, and leads to inflammation response, which often also modifies the microbiota of the skin. Although the healing of incision wounds is well-described, there are fewer studies on superficial wounds. We used a simulated model of skin scratching to study changes in the host transcriptome, skin microbiota, and their relationship. Additionally, we examined the effect of nanosized ZnO, TiO2, and Ag on both intact and damaged skin. At 24 h after exposure, the number of neutrophils was increased, 396 genes were differentially expressed, and microbiota compositions changed between scratched and intact control skin. At 7 d, the skin was still colonised by gut-associated microbes, including Lachnospiraceae, present in the cage environment, while the transcriptomic responses decreased. To sum up, the nanomaterial exposures reduced the relative abundance of cutaneous microbes on healthy skin, but the effect of scratching was more significant for the transcriptome than the nanomaterial exposure both at 24 h and 7 d. We conclude that superficial skin scratching induces inflammatory cell accumulation and changes in gene expression especially at 24 h, while the changes in the microbiota last at least 7 days.

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Itching and treatments in atopic dermatitis (AD): results from the German AD registry TREATgermany

Cited by 3 publications

References 5 publications

Itch, sleep loss, depressive symptoms, fatigue, and productivity loss in patients with moderate‐to‐severe atopic dermatitis: Analyses of TREATgermany registry data

Itch, sleep loss, depressive symptoms, fatigue, and productivity loss in patients with moderate‐to‐severe atopic dermatitis: Analyses of TREATgermany registry data

Juckreiz, Schlafstörungen, depressive Symptome, Fatigue und Einschränkungen der Arbeitsproduktivität bei Patienten mit moderater bis schwerer atopischer Dermatitis: Daten aus dem TREATgermany‐Register

Effects of Superficial Scratching and Engineered Nanomaterials on Skin Gene Profiles and Microbiota in SKH-1 Mice

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