Impact of Atopic Dermatitis on Adult Women’s Lives: A Survey of 1,009 French Women

Authors

  • Anne Claire Fougerousse Military Teaching Hospital Begin, Saint Mandé, France
  • Marina Alexandre Avicenne Hospital, AP-HP, Bobigny, France
  • Anne Sophie Darrigade Saint-André Hospital, Bordeaux, France
  • Stéphanie Merhand Patients experts, French Eczema Association, Redon, France
  • Adrien Marquié Data analyst, Statistician, Paris, France
  • Medhi Hamza Patients experts, LEO Pharma, Voisins-le-Bretonneux, France
  • Gaelle Le Fur Patients experts, Sociologist, Paris, France
  • Marie Jachiet Saint-Louis Hospital, AP-HP, Paris, France
  • Anne Claire Bursztejn Department of Dermatology and Allergology, University Hospital of Nancy, Vandœuvre-lès-Nancy, France
  • Charles Taieb Patient Priority Department, European Market Maintenance Assessment, Fontenay sous Bois, France

DOI:

https://doi.org/10.2340/actadv.v104.10321

Keywords:

atopic dermatitis, women, Quality of Life, sleep

Abstract

Atopic dermatitis (AD) is one of the most common inflammatory diseases, and has a higher prevalence among females in adulthood. The aim of this observational, cross-sectional, survey-based study was to evaluate the impact of AD on the daily lives of adult women patients. A scientific committee composed exclusively of women constructed a specific questionnaire in partnership with the French Eczema Association. Severity of AD was evaluated with the Patient-Oriented Eczema Measure (POEM). A sample of 1,009 adult women (mean age ± standard deviation: 41.8 ± 14.2 years) with AD was identified from a representative sample of the French population (82% response rate 1,230 women surveyed). According to the POEM, 50.64% (n = 511) of subjects were identified as having mild AD, 39.35% (n = 397) moderate AD, and 10.01% (n = 101) severe AD. Overall, 67.7% (n = 682) reported that their eczema involved a visible area (face, neck or hands), and 19.6% (n = 198) a sensual area (breasts/chest, genital area or buttocks). Of the 720 women with menstrual cycles, exacerbations of AD were reported to occur mostly before (50.6%) and during (48.3%) menstruation. A small proportion of women, 7.3% (n = 74), reported being afraid of  becoming pregnant because of their eczema. If AD involvement was in a visible area it had a greater impact on romantic relationships, sexual relationships and occupation. If AD involvement was in a sensual area it had a greater influence on romantic relationships and sexuality. Particular attention should be given to patients with localization of AD on the face, neck or hands, as they have a higher risk of social exclusion. Moreover, these results should encourage health professionals to ask patients with AD about the possible involvement of sensual areas.

Downloads

Download data is not yet available.

References

Bylund S, Kobyletzki LB, Svalstedt M, Svensson Å. Prevalence and incidence of atopic dermatitis: a systematic review. Acta Derm Venereol 2020; 100: adv00160.

https://doi.org/10.2340/00015555-3510 DOI: https://doi.org/10.2340/00015555-3510

Mohn CH, Blix HS, Halvorsen JA, Nafstad P, Valberg M, Lagerløv P. Incidence trends of atopic dermatitis in infancy and early childhood in a nationwide prescription registry study in Norway. JAMA Netw Open 2018; 1:e184145.

https://doi.org/10.1001/jamanetworkopen.2018.4145 DOI: https://doi.org/10.1001/jamanetworkopen.2018.4145

Johansson EK, Bergström A, Kull I, Melén E, Jonsson M, Lundin S, et al. Prevalence and characteristics of atopic dermatitis among young adult females and males-report from the Swedish population-based study BAMSE. J Eur Acad Dermatol Venereol 2022; 36: 698-704.

https://doi.org/10.1111/jdv.17929 DOI: https://doi.org/10.1111/jdv.17929

Richard MA, Paul C, Nijsten T, Gisondi P, Salvalastru C, Taieb C, et al. Prevalence of most common skin diseases in Europe: a population-based study. J Eur Acad Dermatol Venereol 2022; 36: 1088-1096.

https://doi.org/10.1111/jdv.18050 DOI: https://doi.org/10.1111/jdv.18050

Margolis JS, Abuabara K, Bilker W, Hoffstad O, Margolis DJ. Persistence of mild to moderate atopic dermatitis. JAMA Dermatol 2014; 150: 593-600.

https://doi.org/10.1001/jamadermatol.2013.10271 DOI: https://doi.org/10.1001/jamadermatol.2013.10271

Abuabara K, Yu AM, Okhovat JP, Allen IE, Langan SM. The prevalence of atopic dermatitis beyond childhood: a systematic review and meta-analysis of longitudinal studies. Allergy 2018; 73: 696-704.

https://doi.org/10.1111/all.13320 DOI: https://doi.org/10.1111/all.13320

Silverberg JI, Hanifin JM. Adult eczema prevalence and associations with asthma and other health and demographic factors: a US population-based study. J Allergy Clin Immunol 2013; 132: 1132-1128.

https://doi.org/10.1016/j.jaci.2013.08.031 DOI: https://doi.org/10.1016/j.jaci.2013.08.031

Silverberg JI, Gelfand JM, Margolis DJ, Boguniewicz M, Fonacier L, Grayson MH, et al. Patient burden and quality of life in atopic dermatitis in US adults: a population-based cross-sectional study. Ann Allergy Asthma Immunol Off Publ Am Coll Allergy Asthma Immunol 2018; 121: 340-347.

https://doi.org/10.1016/j.anai.2018.07.006 DOI: https://doi.org/10.1016/j.anai.2018.07.006

Eckert L, Gupta S, Amand C, Gadkari A, Mahajan P, Gelfand JM. Impact of atopic dermatitis on health-related quality of life and productivity in adults in the United States: an analysis using the National Health and Wellness Survey. J Am Acad Dermatol 2017; 77: 274-279.e3.

https://doi.org/10.1016/j.jaad.2017.04.019 DOI: https://doi.org/10.1016/j.jaad.2017.04.019

Laughter MR, Maymone MBC, Mashayekhi S, Arents BWM, Karimkhani C, Langan SM, et al.The global burden of atopic dermatitis: lessons from the Global Burden of Disease Study 1990-2017. Br J Dermatol 2021; 184: 304-309.

https://doi.org/10.1111/bjd.19580 DOI: https://doi.org/10.1111/bjd.19580

Birdi G, Larkin M, Knibb RC. Prospective analysis of the temporal relationship between psychological distress and atopic dermatitis in female adults: a preliminary study. Healthc Basel Switz 2022; 10: 1913.

https://doi.org/10.3390/healthcare10101913 DOI: https://doi.org/10.3390/healthcare10101913

Drucker AM, Wang AR, Li WQ, Sevetson E, Block JK, Qureshi AA. The burden of atopic dermatitis: summary of a report for the National Eczema Association. J Invest Dermatol 2017; 137: 26-30.

https://doi.org/10.1016/j.jid.2016.07.012 DOI: https://doi.org/10.1016/j.jid.2016.07.012

Ali F, Vyas J, Finlay AY. Counting the burden: atopic dermatitis and health-related quality of life. Acta Derm Venereol 2020; 100: adv00161.

https://doi.org/10.2340/00015555-3511 DOI: https://doi.org/10.2340/00015555-3511

Charman CR, Venn AJ, Williams HC. The patient-oriented eczema measure: development and initial validation of a new tool for measuring atopic eczema severity from the patients' perspective. Arch Dermatol 2004; 140: 1513-1519.

https://doi.org/10.1001/archderm.140.12.1513 DOI: https://doi.org/10.1001/archderm.140.12.1513

Charman CR, Venn AJ, Ravenscroft JC, Williams HC. Translating Patient-Oriented Eczema Measure (POEM) scores into clinical practice by suggesting severity strata derived using anchor-based methods. Br J Dermatol 2013; 169: 1326-1332.

https://doi.org/10.1111/bjd.12590 DOI: https://doi.org/10.1111/bjd.12590

Creadore A, Manjaly P, Li SJ, Tkachenko E, Zhou G, Joyce C, et al. Evaluation of stigma toward individuals with alopecia. JAMA Dermatol 2021; 157: 392-398.

https://doi.org/10.1001/jamadermatol.2020.5732 DOI: https://doi.org/10.1001/jamadermatol.2020.5732

Pearl RL, Wan MT, Takeshita J, Gelfand JM. Stigmatizing attitudes toward persons with psoriasis among laypersons and medical students. J Am Acad Dermatol 2019; 80: 1556-1563.

https://doi.org/10.1016/j.jaad.2018.08.014 DOI: https://doi.org/10.1016/j.jaad.2018.08.014

Misery L, Finlay AY, Martin N, Boussetta S, Nguyen C, Myon E, et al. Atopic dermatitis: impact on the quality of life of patients and their partners. Dermatol Basel Switz 2007; 215: 123-129.

https://doi.org/10.1159/000104263 DOI: https://doi.org/10.1159/000104263

Holm EA, Esmann S, Jemec GBE. Does visible atopic dermatitis affect quality of life more in women than in men? Gend Med 2004; 1:125-30.

https://doi.org/10.1016/S1550-8579(04)80017-2 DOI: https://doi.org/10.1016/S1550-8579(04)80017-2

Augustin M, Misery L, von Kobyletzski L, Mealing S, Redding M, Chuang CC, et al. Systematic literature review assessing the overall costs and societal impacts of moderate-to-severe atopic dermatitis in Europe. J Eur Acad Dermatol Venereol 2022; 36: 2316-2324.

https://doi.org/10.1111/jdv.18481 DOI: https://doi.org/10.1111/jdv.18481

Stingeni L, Belloni Fortina A, Baiardini I, Hansel K, Moretti D, Cipriani F. Atopic dermatitis and patient perspectives: insights of bullying at school and career discrimination at work. J Asthma Allergy 2021; 14: 919-928.

https://doi.org/10.2147/JAA.S317009 DOI: https://doi.org/10.2147/JAA.S317009

Tableaux de l'économie française édition 2020. Insee. (n.d.). [Accessed 2022 November 17]. Available from: https://www.insee.fr/fr/statistiques/4277649?sommaire = 4318291

Linares-Gonzalez L, Lozano-Lozano I, Gutierrez-Rojas L, Lozano-Lozano M, Rodenas-Herranz T, Ruiz-Villaverde R. Sexual dysfunction and atopic dermatitis: a systematic review. Life Basel Switz 2021; 11: 1314.

https://doi.org/10.3390/life11121314 DOI: https://doi.org/10.3390/life11121314

Linares-Gonzalez L, Lozano-Lozano I, Gutierrez-Rojas L, Ruiz-Villaverde R, Lozano-Lozano M. Sexual dysfunction in a cohort of patients with moderate-to-severe atopic dermatitis. Influence of dupilumab treatment. Int J Dermatol 2022; 61: 607-610.

https://doi.org/10.1111/ijd.15938 DOI: https://doi.org/10.1111/ijd.15938

Ludwig CM, Fernandez JM, Hsiao JL, Shi VY. The interplay of atopic dermatitis and sexual health. Dermatitis 2020; 31: 303-308.

https://doi.org/10.1097/DER.0000000000000617 DOI: https://doi.org/10.1097/DER.0000000000000617

Kemmett D, Tidman MJ. The influence of the menstrual cycle and pregnancy on atopic dermatitis. Br J Dermatol 1991; 125: 59-61.

https://doi.org/10.1111/j.1365-2133.1991.tb06041.x DOI: https://doi.org/10.1111/j.1365-2133.1991.tb06041.x

Maccari F, Fougerousse AC, Reguiai Z, Taieb C. Contraception, sexuality and pregnancy in women with psoriasis: real-life experience of 235 women. Clin Cosmet Investig Dermatol 2020; 13: 817-23.

https://doi.org/10.2147/CCID.S275512 DOI: https://doi.org/10.2147/CCID.S275512

Cho S, Kim HJ, Oh SH, Park CO, Jung JY, Lee KH. The influence of pregnancy and menstruation on the deterioration of atopic dermatitis symptoms. Ann Dermatol 2010; 22: 180-185.

https://doi.org/10.5021/ad.2010.22.2.180 DOI: https://doi.org/10.5021/ad.2010.22.2.180

Rakita U, Kaundinya T, Silverberg JI. Lack of association between atopic dermatitis severity and worsening during pregnancy: a cross-sectional study. J Am Acad Dermatol 2022; 86: 438-40.

https://doi.org/10.1016/j.jaad.2021.09.066 DOI: https://doi.org/10.1016/j.jaad.2021.09.066

Alcantara-Luna S, Ruiz-Villaverde R, Domínguez-Cruz J, et al. Validation of a questionnaire to assess the perception of women with atopic dermatitis in family planning. Int J Environ Res Public Health 2022; 19: 10753.

https://doi.org/10.3390/ijerph191710753 DOI: https://doi.org/10.3390/ijerph191710753

Rakita U, Kaundinya T, Silverberg JI. Association of atopic dermatitis severity with menstrual worsening of disease in women: a cross-sectional study. J Eur Acad Dermatol Venereol 2022; 36: e197-e199.

https://doi.org/10.1111/jdv.17730 DOI: https://doi.org/10.1111/jdv.17730

Kiriyama K, Sugiura H, Uehara M. Premenstrual deterioration of skin symptoms in female patients with atopic dermatitis. Dermatol Basel Switz 2003; 206: 110-102.

https://doi.org/10.1159/000068463 DOI: https://doi.org/10.1159/000068463

Bello GD, Maurelli M, Schena D, Gisondi P, Girolomoni G. Variations of symptoms of atopic dermatitis and psoriasis in relation to menstrual cycle. J Am Acad Dermatol 2022; 87: 892-895.

https://doi.org/10.1016/j.jaad.2021.12.014 DOI: https://doi.org/10.1016/j.jaad.2021.12.014

Additional Files

Published

2024-05-13

How to Cite

Fougerousse, A. C., Alexandre, M., Darrigade, A. S., Merhand, S., Marquié, A., Hamza, M., Le Fur, G., Jachiet, M., Bursztejn, A. C., & Taieb, C. (2024). Impact of Atopic Dermatitis on Adult Women’s Lives: A Survey of 1,009 French Women. Acta Dermato-Venereologica, 104, adv10321. https://doi.org/10.2340/actadv.v104.10321

Issue

Section

Articles

Funding data