Abstract

Atopic dermatitis (AD) is the foremost non-fatal skin-related disease that affects all age groups. Despite the growing prevalence of AD in low- and middle-income countries, its physiological consequences remain overlooked in countries like Bangladesh. Therefore, we aim to assess and characterize the influence of AD on the health-related quality of life (HRQoL) in Bangladeshi patients. A cross-sectional study comprising 184 eligible adults (83 men and 101 women; mean age, 33.46 ± 15.44 years) was conducted at the dermatology outpatient department of Shaheed Suhrawardy Medical College Hospital (a tertiary hospital in Dhaka, Bangladesh). AD was determined using the UK Working Party criteria. A structured questionnaire, Eczema Area and Severity Index (EASI), and Dermatology Life Quality Index (DLQI) were administered to obtain information on patient characteristics, AD severity, and HRQoL. The mean DLQI score for the entire sample was 11.29 ± 5.27 (range, 1–26), and 51.60% reported the disease greatly affected their lives. Bivariate analysis revealed significant differences in self-rated health measures of DLQI scores in terms of self-reported AD severity, overall health, and the EASI. In multivariable regression models adjusted for patient characteristics, the self-perceived severe AD group reported significantly higher DLQI scores (coefficient = 2.72; 95% confidence interval (CI) = 0.38–5.05; p = 0.022) than the mild group. Concurrently, we observed a substantial increase in the DLQI scores among patients with moderate and severe EASI scores (coefficient = 1.96, 95% CI = 0.08–3.92, p < 0.05 and coefficient = 4.35, 95% CI = 1.98–6.72, p < 0.001, respectively) than in those with mild EASI scores, suggesting that HRQoL was markedly influenced by greater AD severity. These findings highlight the need for a more patient-centric approach to the management of AD in order to alleviate patient suffering and, thereby, improve HRQoL.

Highlights

  • Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disorder characterized by frequent exacerbations of pruritic and eczematous lesions [1]

  • DLQI: Dermatology Life Quality Index; ref : used as reference; AD: atopic dermatitis; EASI: Eczema Area and Severity Index; B: unstandardized regression coefficient B; SE: standard error; values in bold are significant. a EASI categorized as: scores 15. This is the first study in Bangladesh to assess health-related quality of life (HRQoL) and associated factors in adults with AD, including a test to investigate the internal consistency reliability of the DLQI items

  • We examined the influence of AD on HRQoL in association with disease severity, measured using both the clinical objective scoring system EASI and self-rated global AD severity

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Summary

Introduction

Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disorder characterized by frequent exacerbations of pruritic and eczematous lesions [1].

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