Burden and characteristics of skin pain among children with atopic dermatitis

Clinical Implications Skin pain is a distinct, burdensome symptom of childhood atopic dermatitis, with heterogeneous presentation and multiple atopic dermatitis phenotypes. [...]skin pain intensity is associated with significant decrements in quality of life, independent of atopic dermatitis severity. Median skin pain intensity was 5.5 and was more intense in children with more severe disease. [...]skin pain intensity was associated with worse overall QOL in disease severity–adjusted models, similar to previous studies that found that AD-induced pruritus is associated with worse QOL.3 Yet, it is unclear whether the differences in QOL are clinically significant. Skin pain is a distinct, burdensome symptom of childhood AD with heterogeneous presentation and AD phenotypes. [...]skin pain intensity was associated with significant decrements on QOL, independent of disease severity. Given the link between skin pain and the severity of AD, skin pain may be an important end point for monitoring treatment response.Online Repository Characteristic Pain intensity, median (IQR) Bivariable model Multivariable model∗ Crude β (95% CI) P value Adjusted β (95% CI) P value Sex Male 5.46 (3.35) 1.00 (reference) — 1.00 (reference) — Female 5.55 (3.48) 0.24 (−0.56 to 1.03) .56 0.20 (−0.52 to 0.91) .58 Race and ethnicity Black 6.25 (2.21) 1.38 (0.50 to 2.25) .002 1.28 (0.53 to 2.03) .001 Other/multiracial 5.80 (3.43) 0.55 (−0.38 to 1.49) .24 0.67 (−0.23 to 1.56) .14 White 5.04 (3.32) 1.00 (reference) — 1.00 (reference) — Current age (y) 1-4 6.06 (3.34) −0.24 (−1.37 to 0.89) .68 −0.23 (−1.26 to 0.81) .67 5-7 3.72 (2.22) −1.38 (−2.41 to −0.34) .01 −1.25 (−2.18 to −0.32) .009 8-12 6.14 (2.03) 0.41 (−0.66 to 1.47) .45 0.16 (−0.89 to 1.22) .76 13-17 5.50 (3.50) 1.00 (reference) — 1.00 (reference) — Proxy POEM AD severity Almost clear/mild 3.13 (1.86) 1.00 (reference) — 1.00 (reference) — Moderate-very severe 5.73 (3.17) 2.18 (1.26 to 3.09)