ORIGINAL ARTICLE   

Minerva Pediatrica 2017 October;69(5):373-80

DOI: 10.23736/S0026-4946.16.04294-8

Copyright © 2015 EDIZIONI MINERVA MEDICA

language: English

Disease severity and quality of life in children with atopic dermatitis: PO-SCORAD in clinical practice

Daniela BOCCARDI ¹ ✉, Enza D’AURIA ², Federica TURATI ³, Michele DI VITO ², Sabrina SORTINO ², Enrica RIVA ², Amilcare CERRI ¹

¹ Unit of Pediatric Dermatology, Dermatologic Clinic, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy; ² Department of Pediatrics, San Paolo Hospital, University of Milan, Milan, Italy; ³ Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

BACKGORUND: Atopic dermatitis (AD) can significantly compromise the quality of life (QoL). The aim of our investigation was to evaluate whether QoL correlates with AD severity, evaluated through the physician and the patient perspective, in a sample of Italian children.
METHODS: Forty children with AD were evaluated. Disease severity was assessed by the physician and the patients (or their parents) using the SCORAD and the patient-oriented SCORAD (PO-SCORAD) tools, respectively. Patients or their parents completed specific QoL questionnaires (IDQOL/CDLQI). Spearman’s correlation coefficient and non-parametric analysis of covariance were used to analyze the data.
RESULTS: SCORAD e PO-SCORAD were moderately but significantly correlated (ρ Spearman=0.55, P<0.01). QoL scores ranged from 1 to 23, with a median score of 4.0 (higher scores represent more impaired QoL). After adjustment for age and sex, children with SCORAD>40 had significantly higher QoL scores (more impaired QoL) than those with SCORAD≤40 (median QoL of 5 and 4, respectively, P=0.048). Even higher differences emerged when AD severity was self-assessed (median QoL of 6 and 3.5 for children with PO-SCORAD>40 and PO-SCORAD≤40, respectively, P=0.01). AD children with concomitant food allergy had a significantly more impaired QoL than those with AD only (P=0.040). No significant difference in QoL was observed according to sex or age.
CONCLUSIONS: In our sample of AD children, QoL appeared slightly-moderately altered, and increasing disease severity was associated with greater impairment in QoL. SCORAD and PO-SCORAD were fairly correlated and the association of QoL was somewhat stronger with the PO-SCORAD than the SCORAD Index. This supports the usefulness of PO-SCORAD for the self-assessment of AD in children, and suggests the importance to integrate physician and patient perspectives in the management of AD.

KEY WORDS: Dermatitis, atopic - Child - Quality of life