Validating a Quality-of-Life Instrument for Allergic Contact Dermatitis

Botto, Nina; Raffi, Jodie; Trivedi, Megha; Ramirez, Faustine D.; Allen, Isabel Elaine; Chren, Mary‐Margaret

doi:10.1097/der.0000000000000515

Cited by 12 publications

(12 citation statements)

References 13 publications

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“…137 Validated ACD-specific questionnaires have shown that the emotional aspect of the disease is most burdensome, a measure that improved months after allergen avoidance. 138,139 The significant impact on the patient, his or her caregivers, and medical professionals undermines the importance of suspicion for and diagnosis of pediatric ACD. Part 2 of this CME will focus on diagnosis through patch testing and management strategies.…”

Section: Quality Of Lifementioning

confidence: 99%

Pediatric allergic contact dermatitis. Part I: Clinical features and common contact allergens in children

Neale

Garza-Mayers

Tam

et al. 2021

Journal of the American Academy of Dermatology

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Allergic contact dermatitis (ACD), a delayed hypersensitivity skin reaction to environmental allergens, has a prevalence that is similar in children and adults. However, diagnostic testing for ACD in pediatric populations accounts for less than one tenth of all patch tests. The relative infrequency of pediatric patch testing may be attributed to the difficulty in testing in this population, which includes a smaller surface area for patch test placement and maintaining cooperation during patch testing, especially in younger children. Diagnosis can be difficult in children because the appearance of ACD can mimic other common pediatric skin conditions, particularly atopic dermatitis and irritant contact dermatitis. Comprehensive history taking, guided by patient presentation, age group, and location of dermatitis, helps build clinical suspicion. Such clinical suspicion is one of the major reasons behind patch testing, with additional indications being recalcitrant dermatitis and dermatitis with atypical distribution. US pediatric data have shown the top allergens to be metals, fragrances, topical antibiotics, preservatives, and emollients. These trends are important to recognize to guide management and accurate diagnosis, because ACD tends to persist if the allergen is not identified and can affect patients' quality of life.

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Section: Quality Of Lifementioning

confidence: 99%

Pediatric allergic contact dermatitis. Part I: Clinical features and common contact allergens in children

Neale

Garza-Mayers

Tam

et al. 2021

Journal of the American Academy of Dermatology

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“…Pruritus is the typical symptom of ACD. Despite the significant prevalence of ACD (it is estimated between 15 and 20% in the general population), the impact of this condition on QoL is poorly known and little has been published about the quantification of QoL of ACD patients [ 32 , 33 ]. Assessment of the extent of QoL changes in patients with ACD is based on symptoms, feelings, function, occupation and treatment [ 34 , 35 ].…”

Section: Main Textmentioning

confidence: 99%

“…Patients with ACD reported being bothered most by eczematous skin lesions, itching and the predisposition to persistence of disease [ 31 ]. The clinical presentation, especially if localized on the hands or face, often causes reduced esteem by self and others with a high risk for depression and anxiety [ 32 , 36 ] The impact on the QoL is greater, the greater the severity of disease [ 37 ]. Ayala et al demonstrated that four main aspects (itching, discomfort, difficulty in carrying out daily activities, and difficulty using hands at work) are of utmost importance in influencing the QoL of CD patients.…”

Section: Main Textmentioning

confidence: 99%

“…ACD patients with chronic severe hand eczema can have an important functional impact in terms of limitation in manual skills and difficulty in carrying out the common gestures of daily life, as buttoning up, opening a bottle, and in many other activities. Considering that ACD and ICD represent about 90% of occupational skin diseases, occupational setting, particularly if hands are affected, is also frequently impaired, contributing to lengthy absences from work (“sick-leave”) and negatively impacting also in the socioeconomic area of the whole society [ 32 ]. In addition, ACD can result in “disability”, meaning the loss of ability in doing the working activity as compared before the disease onset.…”

Section: Main Textmentioning

confidence: 99%

“…The instruments available to assess the burden of ACD on the HRQoL of patients are questionnaires that range from generic to disease-specific [ 37 , 45 , 48 – 52 ]. The most commonly used dermatology-specific QoL questionnaires in patients with ACD are the DLQI [ 39 , 53 , 54 ], the Skindex-29 or Skindex-16 [ 32 , 33 , 43 , 55 ], and the DSQL [ 9 , 56 ]. The DSQL had been originally validated in patients with contact dermatitis, but its use in this patient population is limited in the literature [ 9 , 37 ].…”

Section: Main Textmentioning

confidence: 99%

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Quality of life in patients with allergic and immunologic skin diseases: in the eye of the beholder

et al. 2021

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Allergic and immunologic skin diseases negatively impact the quality of life (QoL) of affected patients with detrimental consequences. Nonetheless, in everyday clinical practice the evaluation of QoL is often overlooked. Considering the increasing prevalence of atopic dermatitis, allergic contact dermatitis, hereditary angioedema, cutaneous mastocytosis, and urticaria, it is essential to determine the effects of allergic and immunologic skin diseases on QoL. A joint meeting (GET TOGETHER 2021) of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC) and the Italian Society of Allergological, Occupational and Environmental Dermatology (SIDAPA) aimed to summarize the features of the main QoL tools used in these diseases and to describe the extent of QoL impairment as well as the impact of treatments on QoL, particularly biologic therapies. The assessment of QoL in patients with allergic and immunologic skin diseases relies on generic, organ-specific and disease-specific questionnaires. While generic and organ-specific questionnaires allow comparison between different diseases, disease-specific questionnaires are designed and validated for specific cohorts: the QoL Index for Atopic Dermatitis (QoLIAD) and the Childhood Atopic Dermatitis Impact Scale (CADIS) in atopic dermatitis, the ACD-11 in allergic contact dermatitis, the Angioedema QoL Questionnaire (AE-QoL) and the Hereditary Angioedema QoL questionnaire (HAE-QoL) in hereditary angioedema, the Mastocytosis QoL Questionnaires (MCQoL e MQLQ) in cutaneous mastocytosis, and the Chronic Urticaria QoL questionnaire (CU-Q2oL) in urticaria. Among the many factors that variably contribute to QoL impairment, pruritus can represent the leading cause of patient discomfort. Biologic therapies significantly ameliorate QoL in atopic dermatitis, hereditary angioedema, mastocytosis and chronic urticaria. In general, adequate management strategies are essential for improving QoL in patients with allergic and immunologic skin diseases.

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