The Symptom Characteristics and the Efficacy of Combining Therapies in Inpatients with Atopic Dermatitis: A Study on Vietnamese Population

Nguyen Thi Thuy Trang; Tran Nguyen Anh Thu; Huynh Nhat Duy; Lac Thi Kim Ngan; Pham Thanh Thao; Huynh Van Ba

doi:10.3889/oamjms.2022.10424

Authors

Nguyen Thi Thuy Trang Department of Dermato-venereology, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam https://orcid.org/0000-0001-6162-1765
Tran Nguyen Anh Thu Clinic of Dermatology and Venerology, Cosmetic Surgery and Skin Aesthetics Center, Can Tho University of Medicine and Pharmacy Hospital, Can Tho, Vietnam https://orcid.org/0000-0003-3598-6490
Huynh Nhat Duy Clinic of Dermatology and Venerology, Cosmetic Surgery and Skin Aesthetics Center, Can Tho University of Medicine and Pharmacy Hospital, Can Tho, Vietnam https://orcid.org/0000-0003-4156-3371
Lac Thi Kim Ngan Department of Dermato-venereology, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
Pham Thanh Thao Department of Dermato-venereology, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
Huynh Van Ba Department of Dermato-venereology, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam

DOI:

https://doi.org/10.3889/oamjms.2022.10424

Keywords:

Atopic dermatitis, Clinical features, Combining therapies, SCORAD, Treatment results

Abstract

Background: Currently, biologics and targeted disease-modifying therapies were developed to provide an effective control for adult with moderate-to-severe atopic dermatitis. This study aimed to describe clinical features, stages, and severity levels of the disease as well as to evaluate the therapeutic efficacy of the combining therapies in adults with atopic dermatitis.

Methods: 128 patients with atopic dermatitis diagnosis based on the Rajka and Hanifi standards at the Inpatient Department of Can Tho Dermato-Venereology Hospital from May 2018 to May 2020 were recruited in this study. The clinical characteristics were recorded. The treatment response was evaluated through the improvement of clinical presentations and the altering SCORAD score.

Results: The study showed that people aged 60 and over made up the largest proportion of total investigated patients. Pruritus was the predominant symptom of atopic dermatitis. There was an association between xerosis symptom and disease severity. After two weeks of treatment, the mean of SCORAD score significantly decreased by more than halved. Additionally, 88.4% of patients showed an excellent response and there was no patient with non/poor improvement.

Conclusions: Our study supports that the combination of therapeutic methods might reduce symptoms in atopic dermatitis patients, and thereby improving their quality of life.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Barbarot S, Auziere S, Gadkari A, Girolomoni G, Puig L, Simpson E, et al. Epidemiology of atopic dermatitis in adults: Results from an international survey. Allergy. 2018;73(6):1284-93. https://doi.org/10.1111/all.13401 PMid:29319189

Sicras-Mainar A, Navarro-Artieda R, Sánchez L, Sastre J. Prevalence of severe atopic dermatitis in adults in 3 areas of Spain. J Investig Allergol Clin Immunol. 2018;28(3):195-7. https://doi.org/10.18176/jiaci.0234 PMid:29939140

Barroso B, Vera-Berrios RN, Rial JM, Fariña-Sabaris MC, Santos LC, Sastre J. Prevalence of severe atopic dermatitis in adults and children in a health area of Madrid, Spain. J Investig Allergol Clin Immunol. 2019;29(1):77-79. PMid:30785113

Nutten S. Atopic dermatitis: Global epidemiology and risk factors. Ann Nutr Metab. 2015;66(Suppl 1):8-16. https://doi.org/10.1159/000370220 PMid:25925336

Hanifin J, Saurat JH. Understanding atopic dermatitis: Pathophysiology and etiology. Introduction. J Am Acad Dermatol. 2001;45(1 Suppl):S1. https://doi.org/10.1067/mjd.2001.117029 PMid:11423860

Habif TP. Clinical Dermatology. Amsterdam: Elsevier Health Sciences; 2015.

Dos Santos Tejada C, Mendoza-Sassi RA, De Almeida HL Jr., Figueiredo PN, Dos Santos Tejada VF. Impact on the quality of life of dermatological patients in Southern Brazil. An Bras Dermatol. 2011;86(6):1113-21. https://doi.org/10.1590/s0365-05962011000600008 PMid:22281898

Wang X, Shi XD, Li LF, Zhou P, Shen YW, Song QK. Prevalence and clinical features of adult atopic dermatitis in tertiary hospitals of China. Medicine (Baltimore). 2017;96(11):e6317. https://doi.org/10.1097/MD.0000000000006317 PMid:28296746

Tsoi LC, Rodriguez E, Stölzl D, Wehkamp U, Sun J, Gerdes S, et al. Progression of acute-to-chronic atopic dermatitis is associated with quantitative rather than qualitative changes in cytokine responses. J Allergy Clin Immunol. 2020;145(5):1406-15. https://doi.org/10.1016/j.jaci.2019.11.047 PMid:31891686

Schmitt J, Langan S, Deckert S, Svensson A, Von Kobyletzki L, Thomas K, et al. Assessment of clinical signs of atopic dermatitis: A systematic review and recommendation. J Allergy Clin Immunol. 2013;132(6):1337-47. https://doi.org/10.1016/j.jaci.2013.07.008 PMid:24035157

Wollenberg A, Barbarot S, Bieber T, Christen-Zaech S, Deleuran M, Fink-Wagner A, et al. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: Part I. J Eur Acad Dermatol Venereol. 2018;32(5):657-82. https://doi.org/10.1111/jdv.14891 PMid:29676534

Bożek A, Reich A. Assessment of intra-and inter-rater reliability of three methods for measuring atopic dermatitis severity: EASI, objective SCORAD, and IGA. Dermatology. 2017;233(1):16-22. https://doi.org/10.1159/000472711 PMid:28494438

Navarro-López V, Ramírez-Boscá A, Ramón-Vidal D, Ruzafa- Costas B, Genovés-Martínez S, Chenoll-Cuadros E, et al. Effect of oral administration of a mixture of probiotic strains on SCORAD index and use of topical steroids in young patients with moderate atopic dermatitis: A randomized clinical trial. JAMA Dermatol. 2018;154(1):37-43. https://doi.org/10.1001/jamadermatol.2017.3647 PMid:29117309

Barbarot S, Wollenberg A, Silverberg JI, Deleuran M, Pellacani G, Armario-Hita JC, et al. Dupilumab provides rapid and sustained improvement in SCORAD outcomes in adults with moderate-to-severe atopic dermatitis: Combined results of four randomized phase 3 trials. J Dermatolog Treat. 2022;33(1):266-77. https://doi.org/10.1080/09546634.2020.1750550 PMid:32347763

Pariser D. Topical corticosteroids and topical calcineurin inhibitors in the treatment of atopic dermatitis: Focus on percutaneous absorption. Am J Ther. 2009;16(3):264-73. https://doi.org/10.1097/MJT.0b013e31818a975c PMid:19262357

Sidbury R, Davis DM, Cohen DE, Cordoro KM, Berger TG, Bergman JN, et al. Guidelines of care for the management of atopic dermatitis: Section 3. Management and treatment with phototherapy and systemic agents. J Am Acad Dermatol. 2014;71(2):327-49. https://doi.org/10.1016/j.jaad.2014.03.030 PMid:24813298

Megna M, Napolitano M, Patruno C, Villani A, Balato A, Monfrecola G, et al. Systemic treatment of adult atopic dermatitis: A review. Dermatol Ther (Heidelb). 2017;7(1):1-23. https://doi.org/10.1007/s13555-016-0170-1 PMid:28025775

Van TC, Tat TN, Lan AT, Van TN, Gandolfi M, Satolli F, et al. Superantigens of Staphylococcus aureus colonization in atopic dermatitis and treatment efficacy of oral cefuroxim in Vietnamese patients. Open Access Maced J Med Sci. 2019;7(2):243-6. https://doi.org/10.3889/oamjms.2019.061 PMid:30745970

Andersen L, Nyeland ME, Nyberg F. Higher self-reported severity of atopic dermatitis in adults is associated with poorer self-reported health-related quality of life in France, Germany, the U.K. and the U.S.A. Br J Dermatol. 2020;182(5):1176-83. https://doi.org/10.1111/bjd.18451 PMid:31437300

Das S, Mitra K, Mandal M. Sample size calculation: Basic principles. Indian J Anaesth. 2016;60(9):652-6. https://doi.org/10.4103/0019-5049.190621 PMid:27729692

Sebok B, Schneider I, Harangi F, Primary Care Paediatricians in Baranya County. Familiar and environmental factors influencing atopic dermatitis in the childhood. J Eur Acad Dermatol Venereol. 2006;20(4):418-22. https://doi.org/10.1111/j.1468-3083.2006.01490.x PMid:16643139

Lee JH, Lee HS, Park MR, Lee SW, Kim EH, Cho JB, et al. Relationship between indoor air pollutant levels and residential environment in children with atopic dermatitis. Allergy Asthma Immunol Res. 2014;6(6):517-24. https://doi.org/10.4168/aair.2014.6.6.517 PMid:25374751

Arruda LK, Yang AC, Aoki V, Criado RF, Pires MC, Lupi O, et al. Clinical features and disease management in adult patients with atopic dermatitis receiving care at reference hospitals in Brazil: The ADAPT study. J Investig Allergol Clin Immunol. 2021;31(3):236-45. https://doi.org/10.18176/jiaci.0478 PMid:31932275

Katoh N, Ohya Y, Ikeda M, Ebihara T, Katayama I, Saeki H, et al. Japanese guidelines for atopic dermatitis 2020. Allergol Int. 2020;69(3):356-69. https://doi.org/10.1016/j.alit.2020.02.006 PMid:32265116

Wollenberg A, Christen-Zäch S, Taieb A, Paul C, Thyssen JP, De Bruin-Weller M, et al. ETFAD/EADV Eczema Task Force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children. J Eur Acad Dermatol Venereol. 2020;34(12):2717-44. https://doi.org/10.1111/jdv.16892 PMid:33205485

Yosipovitch G, Berger T, Fassett MS. Neuroimmune interactions in chronic itch of atopic dermatitis. J Eur Acad Dermatol Venereol. 2020;34(2):239-50. https://doi.org/10.1111/jdv.15973 PMid:31566796

Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM, Simpson EL, et al. Guidelines of care for the management of atopic dermatitis: Section 1. Diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol. 2014;70(2):338-51. https://doi.org/10.1016/j.jaad.2013.10.010 PMid:24290431

Bruscky DM, Melo AC, Sarinho ES. Cross-cultural adaptation and validation of the itching severity scale in children and adolescents with atopic dermatitis. Rev Paul Pediatr. 2017;35(3):244-51. https://doi.org/10.1590/1984-0462/;2017;35;3;00016 PMid:28977301

Thyssen JP, Johansen JD, Zachariae C, Menné T, Linneberg A. Xerosis is associated with atopic dermatitis, hand eczema and contact sensitization independent of filaggrin gene mutations. Acta Derm Venereol. 2013;93(4):406-10. https://doi.org/10.2340/00015555-1539 PMid:23420336

Maliyar K, Sibbald C, Pope E, Sibbald RG. Diagnosis and management of atopic dermatitis: A review. Adv Skin Wound Care. 2018;31(12):538-50. https://doi.org/10.1097/01.ASW.0000547414.38888.8d PMid:30475283

Igarashi A, Fujita H, Arima K, Inoue T, Dorey J, Fukushima A, et al. Health-care resource use and current treatment of adult atopic dermatitis patients in Japan: A retrospective claims database analysis. J Dermatol. 2019;46(8):652-61. https://doi.org/10.1111/1346-8138.14947 PMid:31245879