Presentation: Correlations Between Objective Severity Score and Each of the Subjective Severity Intensity in Atopic Dermatitis ( World Allergy Congress)

Wednesday, 14 October 2015

Hall D1 Foyer (Floor 3) (Coex Convention Center)

Hong Kyu Kang, MD , Dermatology, Yonsei University College of Medicine, Department of Dermatology, Seoul, South Korea

Howard Chu, MD , Dermatology, Yonsei University College of Medicine, Department of Dermatology, Seoul, South Korea

Hemin Lee, MD , Dermatology, Yonsei University College of Medicine, Department of Dermatology, Seoul, South Korea

Jungsoo Lee, MD , Dermatology, Yonsei University College of Medicine, Department of Dermatology, Seoul, South Korea

Jung U Shin, MD , Dermatology, Yonsei University College of Medicine, Department of Dermatology, Seoul, South Korea

Chang Ook Park, MD , Dermatology, Yonsei University College of Medicine, Department of Dermatology, Seoul, South Korea

Kwang Hoon Lee, MD, PhD , Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea

Background: Atopic dermatitis (AD) is a chronic, relapsing, inflammatory skin disorder characterized by multifactorial pathophysiologic aspects. Pruritus and sleep disturbance are cardinal symptom of atopic dermatitis. Several scoring systems are available, Eczema Area and Severity Index (EASI) is a tool commonly used to measure the severity of atopic dermatitis. Correlation between Visual analogue scale (VAS) of pruritus and loss of sleep (LOS) and the EASI score is not fully investigated yet.

Objective: This study was designed to evaluate the association of pruritus and sleep disturbance in atopic dermatitis with objective disease severity and laboratory parameters.

Methods: We assessed EASI score as an objective disease severity, VAS of pruritus and LOS (0-10 point) as a severity of pruritus and sleep disturbance in 1877 AD patients at our dermatology clinic from 2007 to 2013. We also measured Eosinophilic count, total IgE and specific IgE in peripheral blood. Correlation of pruriruts and sleep disturbance with disease severity and laboratory parameters were determined by Pearson’s correleation analysis using SPSS version 21.0.

Results: The mean VAS of pruritus and LOS were 5.93±2.53 (Mean ± SD) and 4.67±3.00. The mean EASI score was 14.0±12.1. Our study revealed that the EASI score showed weak statistical significance with VAS of pruritus and LOS. (EASI vs VAS of pruritus; r = 0.31, EASI vs VAS of LOS; r = 0.36) The eosinophil count revealed weak statistical significance with VAS of pruritus and LOS. (VAS of pruritus; r = 0.10, VAS of LOS; r = 0.23) The total IgE level showed no statistical significance with VAS of pruritus and LOS. Specific IgE titer to Dermatophagoides farinae (D2) showed weak statistical significance with VAS of pruritus and LOS. (VAS of pruritus; r = 0.10, VAS of LOS; r = 0.14)

Conclusions: Our results demonstrated that EASI score weakly reflect the subjective severity (pruritus and LOS). Since severe pruritus and LOS can affect the quality of life of atopic dermtaittis patients and they are not strongly correlated with disease severity measured by dermatologists, dermatologists should aware the subjective symptoms from patients and consider to manage the subjective symptoms together with objective symptoms.

REFERENCES

Chrostowska-Plak D, Salomon J, Reich A, Szepietowski JC. Clinical aspects of itch in adult atopic dermatitis patients. Acta Derm Venereol. 2009;89:379-383.

Hanifin JM. Diagnostic criteria for atopic dermatitis: consider the context. Arch Dermatol. 1999;135:1551.

1108 Correlations Between Objective Severity Score and Each of the Subjective Severity Intensity in Atopic Dermatitis