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Eichenfield LF, Silverberg JI, Hebert AA, Boguniewicz M. Targeting the aryl hydrocarbon receptor as a strategy to expand the therapeutic armamentarium in atopic dermatitis. J DERMATOL TREAT 2024; 35:2300354. [PMID: 38213229 DOI: 10.1080/09546634.2023.2300354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/23/2023] [Indexed: 01/13/2024]
Affiliation(s)
| | - Jonathan I Silverberg
- The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Adelaide A Hebert
- UTHealth McGovern School of Medicine and Children's Memorial Hermann Hospital, Houston, TX, USA
| | - Mark Boguniewicz
- National Jewish Health and University of Colorado School of Medicine, Denver, CO, USA
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2
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Mann C, Staubach P. [Quality of life and sleep quality in patients with chronic pruritus]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2024; 75:612-616. [PMID: 38914832 DOI: 10.1007/s00105-024-05373-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/22/2024] [Indexed: 06/26/2024]
Abstract
Pruritus is defined as a symptom that leads to scratching. Clinically, a heterogeneous group of clinical pictures of different etiology must be considered. Pruritus is characterized by varying intensity and duration. Many patients and/or their social environment, which is influenced by this, cite the impact on sleep quality as an accompanying main symptom. The patient's quality of life is affected depending on the severity of the pruritus and often leads to comorbidity such as depressive disorders or sleep disorders as well as to an impact on psychosocial well-being if it becomes chronic. To date, in addition to the medical history, the established examination methods have been the determination of the disease burden by assessing disease activity, e.g., with validated disease-specific scores, plus the assessment of quality of life using a dermatological quality of life index (DLQI). The latest studies show that this is by no means sufficient to determine the severity of disease and, as a result, to identify adequate treatment options.
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Affiliation(s)
- Caroline Mann
- Haut- und Poliklinik der Johannes Gutenberg Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Petra Staubach
- Haut- und Poliklinik der Johannes Gutenberg Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
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3
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Brunner C, Theiler M, Znoj H, Schwieger-Briel A, Luchsinger I, Weibel L, Seliner B. Corticosteroid fear in parents of children with atopic dermatitis. Pflege 2024; 37:197-203. [PMID: 38294181 DOI: 10.1024/1012-5302/a000968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Background: Topical corticosteroids (TCS) are the mainstay of therapy for paediatric atopic dermatitis (AD). The use of TCS is often met with fear by parents. Assessing this parental TCS fear in clinical practice is still lacking. Aim: The aim was to assess parental fear and beliefs about TCS. Furthermore, we evaluated the quality of life (QoL) of the family and the disease severity of affected children. Methods: We conducted an observational study with a cross-sectional design. Inclusion criteria were children aged 0 to 5 years with a diagnosis of AD and outpatient treatment. The outcome measures were parental fears and beliefs about TCS, assessed with the "Topical Corticosteroid Phobia Score" (TOPICOP), parental QoL evaluated with the "Family Dermatology Life Quality Index", and disease severity, assessed with the "Scoring atopic dermatitis" (SCORAD). Descriptive statistic was used to analyse the data. Results: The current study found that in 40 affected children, 25 (62.5%), suffered from mild AD, 12 (30%) children had moderate AD, and 3 (7.5%) children had severe AD. TCS fear among parents was notable (mean TOPICOP score 18.1, standard deviation (SD) 7.1). The QoL was moderately affected (mean FDLQI score 6.5, SD 2.8). Conclusions: Our study indicates that fear of TCS is prevalent. Furthermore, our data indicate that severity of TCS fear varies markedly between parents, ranging from parents with almost no fear to parents with high levels of fear. For effective education in clinical practice, the individual level of fear must be recognized and taken into account.
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Affiliation(s)
- Corinne Brunner
- Pediatric Skin Center, Skin and Wound Management, University Children's Hospital Zurich, Switzerland
- Children's Research Center, University Children's Hospital of Zurich, University of Zurich, Switzerland
- Graduate School for Health Science, University of Bern, Switzerland
| | - Martin Theiler
- Children's Research Center, University Children's Hospital of Zurich, University of Zurich, Switzerland
- Pediatric Skin Center, Dermatology Department, University Children's Hospital Zurich, Switzerland
| | - Hansjörg Znoj
- Department of Health Psychology and Behavioral Medicine, Institute of Psychology, University of Bern, Switzerland
| | - Agnes Schwieger-Briel
- Children's Research Center, University Children's Hospital of Zurich, University of Zurich, Switzerland
- Pediatric Skin Center, Dermatology Department, University Children's Hospital Zurich, Switzerland
| | - Isabelle Luchsinger
- Children's Research Center, University Children's Hospital of Zurich, University of Zurich, Switzerland
- Pediatric Skin Center, Dermatology Department, University Children's Hospital Zurich, Switzerland
| | - Lisa Weibel
- Children's Research Center, University Children's Hospital of Zurich, University of Zurich, Switzerland
- Pediatric Skin Center, Dermatology Department, University Children's Hospital Zurich, Switzerland
| | - Brigitte Seliner
- Children's Research Center, University Children's Hospital of Zurich, University of Zurich, Switzerland
- Department of Nursing Science, University Children's Hospital Zurich, Switzerland
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4
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Huang Y, Fang F, Chen Y, He X, Chen Q, Wang H, Zhang J. Prenatal exposure to per- and polyfluoroalkyl substances and infant sleep disturbance: A prospective cohort study. ENVIRONMENT INTERNATIONAL 2023; 178:108070. [PMID: 37399769 DOI: 10.1016/j.envint.2023.108070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 06/02/2023] [Accepted: 06/26/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) may adversely affect fetal brain development, yet no study has investigated the potential association between prenatal PFAS exposure and infant sleep. OBJECTIVES To explore the associations of prenatal PFAS exposure with infant sleep disturbances during the first year of life in a prospective cohort study. METHODS We recruited 4127 pregnant women from the Shanghai Birth Cohort (SBC) and followed their children from birth to 12 months old. A total of 2366 infants were included in the 6-month analyses, and 2466 infants in the 12-month analyses. Ten PFAS were quantified in blood serum collected in the first trimester. Sleep quality was measured using the Brief Infant Sleep Questionnaire. We used multiple linear regression and multinomial logistic regression to estimate the individual effects of PFAS on sleep outcomes. We utilized a quantile-based g-computation model to determine the joint effects of the PFAS mixture on infant sleep outcomes. Additionally, generalized estimating equation (GEE) models were performed to examine the longitudinal effects of PFAS exposure during pregnancy. RESULTS In infants aged 6 months, perfluorooctane sulfonate and perfluoroheptanoic acid were associated with a more than 2-fold risk of parent-reported sleep problems as severe. Perfluorodecanoic acid was associated with an increased risk of often or almost always snoring in one-year-old infants (relative risk ratios, 1.79; 95% CI, 1.12-2.86). PFAS mixtures were positively associated with nighttime awakenings both among infants aged 6 months (β, 0.11; 95% CI, 0.04-0.19) and 12 months (β, 0.11; 95% CI, 0.05-0.18). Prenatal exposure to PFAS were associated with longer sleep latency, increased nighttime awakenings, longer nocturnal wakefulness hours, snoring, and earlier sleep-onset time in infants aged 6-12 months, according to GEE models. CONCLUSIONS Our study suggests that prenatal exposure to PFAS may increase the risk of sleep disturbance in infants.
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Affiliation(s)
- Yun Huang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fang Fang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Developmental and Behavioral Pediatric Department & Child Primary Care Department, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Yan Chen
- Department of Neonatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaoqing He
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian Chen
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Wang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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5
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Saeki H, Ohya Y, Nawata H, Arima K, Inukai M, Rossi AB, Bego-Le-Bagousse G. Impact of the Family and Household Environment on Pediatric Atopic Dermatitis in Japan. J Clin Med 2023; 12:jcm12082988. [PMID: 37109324 PMCID: PMC10145633 DOI: 10.3390/jcm12082988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
Pediatric atopic dermatitis (AD) can negatively impact the family quality of life (QoL). We report data from the real-world Epidemiology of Children with Atopic Dermatitis Reporting on their Experience (EPI-CARE) study in Japanese pediatric patients, focusing on disease impact on family QoL. Children and adolescents aged 6 months to <18 years completed an online survey between September 2018-December 2019. The impact of disease severity on family QoL and its effect on parents' time were assessed using the dermatitis family impact (DFI) questionnaire. The impact of a family history of allergic conditions, current residency, second-hand smoke exposure, and household pets on AD prevalence and severity was also assessed. Family QoL decreased as AD severity increased, particularly in families with children aged <6 years; but had the greatest impact on sleep and tiredness in families with children aged <12 years. Parents spent at least 4.6 h/week caring for children <6 years, including those with mild symptoms. Most children (>80%) had a family history of allergic conditions; AD prevalence was increased in those exposed to second-hand smoke or household pets. This study demonstrated that pediatric AD in Japanese individuals has negative impacts on family QoL and that family and household environments can influence pediatric AD prevalence.
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Affiliation(s)
- Hidehisa Saeki
- Department of Dermatology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
| | - Yukihiro Ohya
- Allergy Center, National Center for Child Health and Development, Setagaya-ku, Tokyo 157-8535, Japan
| | - Hisakatsu Nawata
- Immunology Medical, Sanofi K.K., Shinjuku-ku, Tokyo 163-1488, Japan
| | - Kazuhiko Arima
- Immunology Medical, Sanofi K.K., Shinjuku-ku, Tokyo 163-1488, Japan
| | - Miho Inukai
- Market Access, Sanofi K.K., Shinjuku-ku, Tokyo 163-1488, Japan
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6
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Fan Y, Gu R, Zhang R, Wang M, Xu H, Wang M, Long C. Protective effects of extracts from Acer truncatum leaves on SLS-induced HaCaT cells. Front Pharmacol 2023; 14:1068849. [PMID: 37007019 PMCID: PMC10050454 DOI: 10.3389/fphar.2023.1068849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 03/06/2023] [Indexed: 03/17/2023] Open
Abstract
Introduction:A. truncatum Bunge (Sapindaceae or formerly Aceraceae) is a tall deciduous tree native to China. Traditionally, the leaves of A. truncatum are decocted and used by Chinese Mongolians, Koreans, and Tibetans to treat skin itching, dry cracks, and other skin ailments, which indicates A. truncatum leaves may have a potential inhibitory effect on various skin inflammations.Methods: To examine the protective effect against skin inflammations of A. truncatum leaf extract (ATLE), an in vitro dermatitis model was established using sodium dodecyl sulfate (SLS)-induced HaCaT cells. The anti-inflammatory effect of ATLE was evaluated by analyzing cell viability, apoptosis, reactive oxygen species (ROS), interleukin 6 (IL-6), and prostaglandin E2 (PGE2) levels.Results: Orthogonal experiments showed that the pretreatment with ATLE can reduce the IL-6 levels, PGE2 levels, and apoptosis increased in SLS-stimulated HaCaT cells, which indicates that ATLE has positive efficacy for dermatitis. Furthermore, three flavonoid compounds kaempferol-3-O-α-L-rhamnoside, quercetin-3-O-α-L-rhamnopyranoside, kaempferol-3,7-di-O-α-L-rhamnoside, and 1,2,3,4,6-Penta-O-galloyl-β-D-glucopyranose (PGG) were isolated and identified. Among them, kaempferol-3,7-di-O-α-L-rhamnoside was isolated from this plant for the first time. These compounds have been proven to have an anti-inflammatory effect. They may contribute to the efficacy of A. truncatumin treating skin inflammation.Discussion: The results revealed that ATLE has the potential to be used as an additive in various skin care products to prevent skin inflammations and may be incorporated in formulations for topical application as a therapeutic approach against dermatitis.
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7
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Lee DG, Gui XY, Mukovozov I, Fleming P, Lynde C. Sleep Disturbances in Children With Atopic Dermatitis: A Scoping Review. J Cutan Med Surg 2023; 27:157-164. [PMID: 36880965 PMCID: PMC10068401 DOI: 10.1177/12034754231159337] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Atopic dermatitis (AD) is associated with various quality of life concerns including poor sleep. Sleep impairments in children with AD are associated with increased risk of short stature, metabolic syndrome, mental illness and neurocognitive dysfunction. Although the association between AD and sleep disturbance is well established, the specific types of sleep disturbance in pediatric AD patients and their underlying mechanisms are not fully understood. A scoping literature review was performed to characterize and summarize the types of sleep disturbance in children (less than 18 years of age) with AD. 31 papers met inclusion criteria and extracted data were analyzed in an iterative manner. Two types of sleep disturbances were found to be more prevalent in pediatric AD patients in comparison to controls. One category was related to loss of sleep (increased frequency or duration of awakenings, increased sleep fragmentation, delayed sleep onset, decreased total sleep duration, and decreased sleep efficiency). Another category was associated with unusual behaviors during sleep (restlessness/limb movement/scratching, sleep-disordered breathing including obstructive sleep apnea and snoring, nightmares, nocturnal enuresis and nocturnal hyperhidrosis). Some mechanisms underlying these sleep disturbances include pruritus and induced scratching and increased proinflammatory markers induced by sleep loss. Sleep disturbance appears to be associated with AD. We recommend clinicians to consider interventions that may reduce sleep disturbances in children with AD. Further investigation of these sleep disturbances is needed to elucidate pathophysiology, develop additional treatments, and reduce negative impacts on the health outcomes and quality of life in pediatric AD patients.
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Affiliation(s)
- Dong Goo Lee
- 12358 Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Xi Yao Gui
- 12358 Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ilya Mukovozov
- 12358 Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,12358 Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Patrick Fleming
- 12366 Division of Dermatology, University of Toronto, Toronto, ON, Canada
| | - Charles Lynde
- 12366 Division of Dermatology, University of Toronto, Toronto, ON, Canada.,The Lynde Institute for Dermatology, Markham, ON, Canada
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8
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Vittrup I, Andersen YMF, Skov L, Wu JJ, Agner T, Thomsen SF, Egeberg A, Thyssen JP. The association between atopic dermatitis, cognitive function and school performance in children and young adults. Br J Dermatol 2023; 188:341-349. [PMID: 36640132 DOI: 10.1093/bjd/ljac058] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/26/2022] [Accepted: 10/18/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Children with atopic dermatitis (AD) may have disturbed sleep, affected self-esteem and decreased quality of life, likely interfering with performance in school. OBJECTIVES To examine the association between hospital-managed paediatric AD, school performance and cognitive function. METHODS In this cross-sectional study we linked data from the Danish national registers and identified three populations between 2001 and 2019. Population 1 comprised children with graduation grades registered from lower secondary school, population 2 comprised adolescents with registration of an upper secondary graduation mean, and population 3 comprised male conscripts with registration of an IQ test score. AD was defined as a hospital diagnostic code (inpatient or outpatient) prior to the exam or conscription date, and was stratified according to severity, activity and atopic comorbidity. Outcomes included graduation mean from lower and upper secondary school, special educational assistance in primary and lower secondary school, and IQ at conscription. RESULTS In total, 770 611 (12 137 with AD), 394 193 (6261 with AD) and 366 182 (4539 with AD) children and adolescents were included in populations 1 (lower secondary graduation), 2 (upper secondary graduation) and 3 (conscription), respectively. In lower secondary school, children with severe AD had significantly lower overall, written and oral graduation grade means compared with children with mild AD: respectively, difference -0.29 [95% confidence interval (CI) -0.45 to -0.13, P < 0.001], difference -0.26 (95% CI -0.42 to -0.10, P = 0.0016) and difference -0.30 (95% CI -0.49 to -0.11, P = 0.0018). In upper secondary school, adolescents with AD performed similarly to their peers without AD. Young men with AD scored significantly lower IQ test means at conscription examination than male conscripts without AD: difference -0.60 (95% CI -0.87 to -0.32, P < 0.001). CONCLUSIONS AD, in particular when severe, is associated with lower school performance in childhood and IQ in young men, which can interfere with academic achievements in life. Optimization of treatment of children with AD and specific educational support to children with severe AD could be needed.
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Affiliation(s)
- Ida Vittrup
- Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.,Department of Dermatology and Venereology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Yuki M F Andersen
- Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Lone Skov
- Department of Dermatology and Allergy, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Jashin J Wu
- Department of Dermatology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Tove Agner
- Department of Dermatology and Venereology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Simon F Thomsen
- Department of Dermatology and Venereology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Alexander Egeberg
- Department of Dermatology and Venereology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Jacob P Thyssen
- Department of Dermatology and Venereology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
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9
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McKenzie KNA, Comeau J, Reid GJ. Examining the interactive association of family- and neighborhood-level socio-economic characteristics on children's sleep beyond the associations of residency and neighborhood violence. Sleep Health 2022; 8:458-466. [PMID: 35927180 DOI: 10.1016/j.sleh.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 05/30/2022] [Accepted: 06/06/2022] [Indexed: 10/16/2022]
Abstract
OBJECTIVE To examine the interactive association of neighborhood and family socio-economic characteristics (SEC) on children's sleep. DESIGN Secondary data analyses were completed on the 2014 Ontario Child Health Study, a cross-sectional sample of 10,802 children aged 4-17. PARTICIPANTS Children (aged 4-11, 50% male; N = 6264) with available sleep outcome data. METHODS Multilevel modeling was used to assess the interactive relationship between family- and neighborhood-level poverty in relation to child sleep outcomes (problems falling asleep, problems staying asleep, weekday and weekend time in bed), above the associations of variables known to be related to sleep at the child (ie, child age, sex, internalizing problems, externalizing problems, chronic illness), family (ie, negative parenting behaviors, family structure, parent mental health, years lived in neighborhood, parent education level), and neighborhood levels (ie, neighborhood size, antisocial behavior). RESULTS Neighborhood poverty (p < .01, ß = -0.001, 95% confidence interval [-0.007, -0.002]) was significantly related to shorter weekday time in bed and the interactive association of family and neighborhood poverty was significantly related to weekend time in bed (p < .05, ß = 0.012, 95% confidence interval [0.004, 0.021]). Children living in low poverty neighborhoods with families of higher SEC backgrounds, and children living in high poverty neighborhoods with families of lower SEC backgrounds had the shortest weekend time in bed (9.7 hours). CONCLUSIONS There is a compound relationship of family and neighborhood poverty on children's sleep above and beyond family- and child-level risk factors.
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Affiliation(s)
| | - Jinette Comeau
- Department of Sociology, King's University College at Western University, London, ON, Canada; Division of Children's Health and Therapeutics, Children's Health Research Institute, Lawson Health Research Institute, Western University, London, ON, Canada
| | - Graham J Reid
- Department of Psychology, The University of Western Ontario, London, ON, Canada; Division of Children's Health and Therapeutics, Children's Health Research Institute, Lawson Health Research Institute, Western University, London, ON, Canada; Department of Family Medicine, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; Department of Pediatrics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
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10
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Napolitano M, Fabbrocini G, Potestio L, Fontanella G, Picone V, Bennardo L, Scalvenzi M, Patruno C. A 24‐weeks real‐world experience of dupilumab in adolescents with moderate‐to‐severe atopic dermatitis. Dermatol Ther 2022; 35:e15588. [DOI: 10.1111/dth.15588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 04/15/2022] [Accepted: 05/13/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Maddalena Napolitano
- Department of Medicine and Health Sciences Vincenzo Tiberio University of Molise Campobasso Italy
| | - Gabriella Fabbrocini
- Section of Dermatology ‐ Department of Clinical Medicine and Surgery University of Naples Federico II Italy
| | - Luca Potestio
- Section of Dermatology ‐ Department of Clinical Medicine and Surgery University of Naples Federico II Italy
| | - Giuseppina Fontanella
- Section of Dermatology ‐ Department of Clinical Medicine and Surgery University of Naples Federico II Italy
| | - Vincenzo Picone
- Section of Dermatology ‐ Department of Clinical Medicine and Surgery University of Naples Federico II Italy
| | - Luigi Bennardo
- Department of Health Sciences University Magna Graecia of Catanzaro Catanzaro Italy
| | - Massimiliano Scalvenzi
- Section of Dermatology ‐ Department of Clinical Medicine and Surgery University of Naples Federico II Italy
| | - Cataldo Patruno
- Department of Health Sciences University Magna Graecia of Catanzaro Catanzaro Italy
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11
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Ando T, Mori R, Takehara K, Asukata M, Ito S, Oka A. Effectiveness of Pediatric Teleconsultation to Prevent Skin Conditions in Infants and Reduce Parenting Stress in Mothers: Randomized Controlled Trial. JMIR Pediatr Parent 2022; 5:e27615. [PMID: 34678753 PMCID: PMC8895291 DOI: 10.2196/27615] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 06/02/2021] [Accepted: 10/22/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND In Japan, eHealth for infants and mothers is currently an important aspect, but its effectiveness has rarely been examined. For infants, skin problems, including atopic dermatitis (AD), which is known to lead to other allergic diseases, are one of the most common conditions. Mothers of infants are prone to experiencing parenting stress, which adversely affects mothers' and children's well-being. Additionally, studies have reported that AD among offspring enhances parenting stress, and postnatal maternal psychological problems can increase the risk of AD in children. OBJECTIVE This study evaluated the effectiveness of pediatric teleconsultation for preventing AD in infants and reducing parenting stress in mothers in Japan. METHODS The study was an open-label, randomized, parallel-armed controlled trial. In total, 318 pairs of infants and mothers in the Yokohama City Sakae Ward were recruited when they submitted birth cards to the ward, received the explanation about the trial, and provided informed consent on the website for this trial. Eligible pairs of infants and mothers were randomly assigned to the intervention group (n=140) or the control group (n=138). Participants in the intervention and control groups received routine postnatal care from local government services. In addition, participants in the intervention group had the option to combine routine pediatric services with teleconsultation and email newsletters without charge from the date of registration until the infant turned 4 months. Primary outcomes were (1) the prevalence of AD in infants diagnosed based on the United Kingdom Working Party criteria and (2) parenting stress and mental status of mothers assessed using the Parenting Stress Index-Short Form (PSI-SF) and General Health Questionnaire-12 (GHQ-12). Data were collected by the ward office staff and researcher during the 4-month checkup. RESULTS The prevalence of AD in infants was significantly lower in the intervention group than in the control group during the 4-month checkup (20% vs 33%, P=.02; relative risk ratio, 0.614 [95% CI 0.519-0.969]). No significant differences were observed in the PSI-SF and GHQ-12 scores between the 2 groups. There was a significant difference in the prevalence of AD between participants who used teleconsultation services and email newsletters, participants who did not use teleconsultation services but received email newsletters, and participants who neither received nor used either service (18% vs 22% vs 33%, P=.048). CONCLUSIONS This is the first randomized controlled trial demonstrating that routine pediatric care combined with teleconsultation and email newsletters was effective in reducing the prevalence of AD in infants. The findings highlight the potential of pediatric eHealth to become a useful new strategy for preventing AD. TRIAL REGISTRATION University Hospital Medical Information Network Clinical Trials Registry UMIN000029774; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000034022.
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Affiliation(s)
- Tomohisa Ando
- Department of Pediatrics, University of Tokyo, Tokyo, Japan.,Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
| | - Rintaro Mori
- Population Ageing and Sustainable Development, Asia and the Pacific Regional Office, United Nations Population Fund, Bangkok, Thailand
| | - Kenji Takehara
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
| | - Mari Asukata
- Tsurumi Ward Administration Office, Yokohama, Japan
| | - Shuichi Ito
- Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Akira Oka
- Department of Pediatrics, University of Tokyo, Tokyo, Japan
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12
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Zhou NY, Nili A, Blackwell CK, Ogbuefi N, Cummings P, Lai JS, Griffith JW, Paller AS, Wakschlag LS, Fishbein AB. Parent report of sleep health and attention regulation in a cross-sectional study of infants and preschool-aged children with atopic dermatitis. Pediatr Dermatol 2022; 39:61-68. [PMID: 34935180 PMCID: PMC9308997 DOI: 10.1111/pde.14889] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/23/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND/OBJECTIVES Older children with atopic dermatitis (AD) suffer from poor sleep and attention problems. However, until recently, the dearth of developmentally sensitive assessment tools impeded characterization in younger children. We aimed to characterize sleep and attention problems in young children with AD and identify modifiable factors. METHODS A cross-sectional study of children with AD aged 1-4 years was stratified by disease severity (Patient-Oriented Eczema Measure), age, and racial/ethnic groups. Developmentally sensitive surveys assessed attention (Multidimensional Assessment Profile of Attention Regulation), sleep, and itch (Patient-Reported Outcomes Measurement Information System). Linear regression models identified predictors of sleep health and attention dysregulation. RESULTS Parents (n = 60) of children aged 2.78 ± 0.98 years with severe (n = 25), moderate (n = 25), or mild (n = 10) AD were recruited across the United States. Significantly reduced sleep health (T-score ≥ 60) was reported in 86% of children with moderate/severe disease (n = 43), and 50% had ≥5 nights of disturbed sleep per week. A suboptimal sleep environment was identified with 32% of children with too much light, noise, or electronic device usage. With regard to attention regulation, in children with severe AD, 80% had trouble sitting still and 72% of children had trouble paying attention no matter their surroundings. In fully adjusted models, AD severity was a significant predictor of poor sleep health (B = 0.79 [0.31-1.28], p < .01) and attention dysregulation (B = 1.22 [0.51-1.93], p < .01). CONCLUSIONS More severe AD correlates with poor sleep health and attention dysregulation. In addition to aggressive treatment of AD, clinicians should advise on modifiable sleep hygiene practices and consider screening for attention dysregulation in young children.
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Affiliation(s)
- Nina Y Zhou
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Amanda Nili
- Department of Medical Social Sciences and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, Illinois, USA
| | - Courtney K Blackwell
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Nonye Ogbuefi
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Peter Cummings
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jin-Shei Lai
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, Illinois, USA
| | - James W Griffith
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Amy S Paller
- Department of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Lauren S Wakschlag
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, Illinois, USA.,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Anna B Fishbein
- Division of Pediatric Allergy & Immunology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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13
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Vittrup I, Droitcourt C, Andersen YMF, Skov L, Egeberg A, Delevry D, Fenton MC, Thyssen JP. Family burden of hospital-managed pediatric atopic dermatitis: A nationwide registry-based study. Pediatr Allergy Immunol 2022; 33:e13693. [PMID: 34726312 DOI: 10.1111/pai.13693] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/14/2021] [Accepted: 09/30/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Parents of children with atopic dermatitis (AD) report reduced quality of life and higher stress level, which could increase risk of psychiatric and pain disorders, and medication use. METHODS By use of Danish national registries, we identified family members of all first-born Danish children born between 1 January 1995 and 31 December 2013 with a hospital diagnosis of AD, matched them 1:10 with family members of children without AD, and followed the cohorts over time. RESULTS Mothers of children with hospital-managed AD had higher risk of filling a prescription for medications for depression, anxiety, pain and sleep problems, and of consulting a psychologist, but most associations disappeared after full adjustment. Siblings had higher risk of receiving a diagnosis for adjustment disorder, and fathers showed increased risk of filling a prescription for pain medication and of divorce, in crude but not adjusted models. CONCLUSIONS The increased risk of study endpoints seen in mothers of children with hospital-managed AD was not explained by pediatric AD alone. Rather, the total burden in these families including parent and child morbidity and socioeconomic resources seems to explain these observations. The burden in families of children with AD may potentially affect the overall management of their child's AD.
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Affiliation(s)
- Ida Vittrup
- Department of Dermatology and Allergy, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark.,Department of Dermatology and Venereology, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Catherine Droitcourt
- Department of Dermatology and Allergy, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark.,Department of Dermatology, CHU Rennes, Rennes, France.,University of Rennes, EA 7449 REPERES "Pharmacoepidemiology and Health Services Research", Rennes, France
| | - Yuki M F Andersen
- Department of Dermatology and Allergy, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark
| | - Lone Skov
- Department of Dermatology and Allergy, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark
| | - Alexander Egeberg
- Department of Dermatology and Allergy, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark
| | | | | | - Jacob P Thyssen
- Department of Dermatology and Venereology, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
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14
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Hui-Beckman J, Leung DYM. The importance of considering mental health in the management of atopic dermatitis across the lifespan. Ann Allergy Asthma Immunol 2021; 127:159-160. [PMID: 34348850 DOI: 10.1016/j.anai.2021.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 04/16/2021] [Indexed: 10/20/2022]
Affiliation(s)
| | - Donald Y M Leung
- Department of Pediatrics, National Jewish Health, Denver, Colorado.
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15
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Sundell AL, Angelhoff C. Sleep and its relation to health-related quality of life in 3-10-year-old children. BMC Public Health 2021; 21:1043. [PMID: 34078330 PMCID: PMC8173783 DOI: 10.1186/s12889-021-11038-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 05/11/2021] [Indexed: 11/17/2022] Open
Abstract
Background Considering the reports of increasing sleep problems in children, affecting health and well-being in young children and their families, we found it important to gain more knowledge about sleep and its correlation to health-related quality of life (HRQoL) in young, healthy children. The aims with this study were to describe sleep quality, sleep duration, and HRQoL in healthy 3–10-year-old children and to test associations between children’s sleep and HRQoL. Methods Parents of 160 children (average age: 6.9 years, SD ±2.2) participated in the study. Sleep onset problems (SOP), sleep maintenance problems (SMP), and sleep duration were measured by the Pediatric Insomnia Severity Index (PISI). KIDSCREEN-27 was used to measure HRQoL in five dimensions: physical well-being, psychological well-being, autonomy and parent relation, social support and peers, and school environment. Results The average score was 2.2 for SOP (SD +/− 2.2) and 1.3 for SMP (SD +/− 1.6). Few children (2%) were reported to sleep less than 8 h per night. Younger children had statistically significant higher SOP and SMP than older children. Correlations were found between SOP and poor psychological well-being (p < 0.05, ρ = − 0.16), and between SMP and poor physical wellbeing (p < 0.05, ρ = − 0.16), psychological well-being (p < 0.05, ρ = − 0.21), poor school environment (p < 0.01, ρ = − 0.29), autonomy and parent relation (p < 0.05, ρ = − 0.16), and poor social support and peers (p < 0.05, ρ = − 0.19). Conclusion Children’s sleep associates with health-related quality of life and needs to be acknowledged in child health care settings and schools.
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Affiliation(s)
- Anna Lena Sundell
- Department of Pediatric Dentistry, Institute for Postgraduate Dental Education, Jönköping, Sweden.,Centre of Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Charlotte Angelhoff
- Crown Princess Victoria's Child and Youth Hospital, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
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16
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Cheng BT, Silverberg JI. Association of pediatric atopic dermatitis and psoriasis with school absenteeism and parental work absenteeism: A cross-sectional United States population-based study. J Am Acad Dermatol 2021; 85:885-892. [PMID: 33667540 DOI: 10.1016/j.jaad.2021.02.069] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 02/07/2021] [Accepted: 02/25/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The impact of childhood atopic dermatitis (AD) and psoriasis on school absenteeism is not fully elucidated. OBJECTIVE To determine the burden and predictors of chronic school absenteeism in children with AD and psoriasis. METHODS Data were analyzed from the 1999-2015 Medical Expenditure Panel Surveys, cross-sectional, population-based studies of health status and function in the United States. RESULTS Among 3132 and 200 children with AD and psoriasis, respectively, 1544 (67.7%) and 97 (62.5%) missed ≥1 day, and 120 (3.9%) and 5 (3.6%) missed ≥15 days (chronically absent) per year due to illness. AD was associated with chronic absenteeism overall (logistic regression; adjusted odds ratio 1.42, 95% CI [1.13-1.78]) and with more severe disease (mild-moderate: 1.33 [1.04-1.70], severe: 2.00 [1.21-3.32]). No statistical difference in chronic absenteeism was found for children with versus those without psoriasis (1.26 [0.51-3.12]). Parents of children with AD were more likely to miss work for caregiving versus those of children without AD, whereas parents of children with psoriasis had similar rates of work absenteeism versus those of children without psoriasis. LIMITATIONS The severity of AD and psoriasis was assessed by treatment pattern. CONCLUSION Children in the United States with AD had increased chronic school absenteeism. Further interventions are warranted to prevent school absenteeism in childhood AD.
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Affiliation(s)
- Brian T Cheng
- Department of Allergy & Immunology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC.
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