National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 121 Research Studies DisplayedPatel KR, Justiz AM, Ahmed AM
Association of vitiligo and inflammatory arthropathy in hospitalized US adults.
The purpose of this study was to explore the relationships between vitiligo and autoimmune arthropathies. The researchers analyzed data from the 2002-2016 Nationwide Inpatient Sample (NIS) according to Healthcare Cost and Utilization Project (HCUP) policies. Between 2002 and 2016, 96,970,768 admissions were captured, including 18,231 (0.02%) with vitiligo. The study found that vitiligo was significantly associated with higher odds of any inflammatory arthritis, psoriatic arthritis, rheumatoid arthritis, and other inflammatory arthritis, with a trend toward significance with reactive arthritis and ankylosing spondylitis.
AHRQ-funded; HS023011.
Citation: Patel KR, Justiz AM, Ahmed AM .
Association of vitiligo and inflammatory arthropathy in hospitalized US adults.
J Am Acad Dermatol 2023 Dec; 89(6):1256-57. doi: 10.1016/j.jaad.2023.07.1015..
Keywords: Arthritis, Chronic Conditions, Skin Conditions
Erickson T, Daftary K, Quan VL
Capturing the diversity of dermatology-what's in a name?
This article discusses the use of the term skin of color (SOC) in dermatology and how certain individuals with less skin pigment may socially consider themselves to be SOC, while the inverse is true. The authors sought to highlight strengths and weaknesses of the current terminology used in SOC dermatology and recommend a more holistic understanding of reported differences, including a framework reflective of upstream socioeconomic, environmental, and historical factors that may be most relevant to reported associations.
AHRQ-funded; HS026385.
Citation: Erickson T, Daftary K, Quan VL .
Capturing the diversity of dermatology-what's in a name?
Am J Clin Dermatol 2023 Sep; 24(5):675-80. doi: 10.1007/s40257-023-00800-9..
Keywords: Skin Conditions, Racial and Ethnic Minorities
Smith JH, Silverberg JI
Correlation of clinician-reported outcomes with patient-reported outcomes by race and ethnicity in patients with atopic dermatitis.
This study examined the correlation of clinician-reported outcome measures (ClinROMs) with patient-reported outcomes by race and ethnicity in patients with atopic dermatitis (AD). A prospective, dermatology practice-based study was conducted with children and adults with AD for patients enrolled January 2014 through September 2019. Electronic surveys were completed by patients or caregivers, including self-identified race and Hispanic ethnicity, Numerical Rating Scale (NRS) for average itch in the past 7 days, and Patient Oriented Eczema Measure (POEM). Different severity indexes including Ezcema Area and Severity Index (EASI), and objective-SCORing Atopic Dermatitis Index (SCORAD) were used by a dermatologist to perform total body skin assessments. Spear correlations were performed for POEM and NRS-itch versus objective-SCORAD and EASI. Overall, 1987 patients were included in the study (age less than 18 years: 101 [5.08%], age greater or equal to 18 years: 1886 [94.92%]), including 198 (9.96%) Black, 360 (18.12%) Asian, 8 (0.40%) Multiracial/Other, 1313 (66.08%) White, and 108 (5.44%) Hispanic. Black patients had a moderate correlation for POEM with objective-SCORAD and EASI, while NRS average-itch had a weak-moderate correlation. In White patients there were strong correlations for both measures. Patients who were Asian/Pacific Islander had numerically weaker correlations of POEM but strong or very strong correlations of NRS average-itch with objective-SCORAD and EASI compared to White patients while patients with Hispanic ethnicity also showed numerically weaker correlations for POEM with objective-SCORAD and EASI, and weaker correlations of NRS average-itch with EASI.
AHRQ-funded; HS023011.
Citation: Smith JH, Silverberg JI .
Correlation of clinician-reported outcomes with patient-reported outcomes by race and ethnicity in patients with atopic dermatitis.
J Am Acad Dermatol 2023 Sep; 89(3):579-80. doi: 10.1016/j.jaad.2023.04.050..
Keywords: Racial and Ethnic Minorities, Skin Conditions, Outcomes
Jackson-Cowan L, Silverberg JI
Longitudinal course of cognitive impairment in patients with atopic dermatitis.
This study’s objective was to investigate the longitudinal course predictors of cognitive impairment (CI) in atopic dermatitis (AD). A prospective dermatology practice-based study was performed using questionnaires and evaluation by a dermatologist (n = 210). Patients with 2 or more visits were included, and cognitive function was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Cognitive Function 8-item Short-Form. At baseline, 20.85% of patients had PROMIS T scores greater or equal to 45, indicating CI. Among patients with baseline CI, 34.09% had persistent CI, 47.72% had a fluctuating course, and 18.18% had sustained improvement of cognitive function. In repeated-measures regression models, cognitive function scores declined overtime in patients with worse AD severity [SCORing Atopic Dermatitis (SCORAD), Atopic Dermatitis Severity Index:, increased itch, skin pain, and sleep disturbance. Persistent CI was associated with female gender and depressive symptoms. Two classes of cognitive dysfunction were identified using latent class analysis: normal cognition (77.23%), moderate dysfunction (16.21%) and severe impairment (6.55%). Black/African-American race, moderate-to-severe SCORAD, dermatology life quality index, Patient Health Questionnaire-9 (PHQ9), itch and skin pain were more likely to experience moderate dysfunction or severe cognitive impairment.
AHRQ-funded; HS023011.
Citation: Jackson-Cowan L, Silverberg JI .
Longitudinal course of cognitive impairment in patients with atopic dermatitis.
Arch Dermatol Res 2023 Aug; 315(6):1553-60. doi: 10.1007/s00403-023-02536-2..
Keywords: Skin Conditions
Pagani K, Lukac D, Olbricht SM
Urgent referrals from primary care to dermatology for lesions suspicious for skin cancer: patterns, outcomes, and need for systems improvement.
The purpose of this study was to explore primary care and dermatology triaging and processing of urgent dermatology referrals. The researchers conducted chart reviews of all dermatology referrals designated by primary care as urgent for evaluation of a lesion concerning for skin cancer. Dermatology encounters for patients occurred on or before 30 days for 50.6% of referrals and on or after 31 days for 38.4% of referrals, with 10.9% never completed. The rate of non-English languages in the delayed group was 7.1% greater than in the timely group. The rate of all races excluding whites, non-Hispanic in the delayed appointment group (31 days or more) was 15.1% greater than in the timely appointment group (30 days or less). Overall, 15.8% of referrals yielded malignancy diagnoses, while 76.8% and 7.4% resulted in benign and pre-malignant diagnoses, respectively. The primary care team documented completed, incomplete, or pending referral status during their subsequent visits with the patients in only 37.5% of the referrals.
AHRQ-funded; HS027282.
Citation: Pagani K, Lukac D, Olbricht SM .
Urgent referrals from primary care to dermatology for lesions suspicious for skin cancer: patterns, outcomes, and need for systems improvement.
Arch Dermatol Res 2023 Jul; 315(5):1397-400. doi: 10.1007/s00403-022-02456-7..
Keywords: Cancer: Skin Cancer, Cancer, Primary Care, Skin Conditions, Access to Care
Chatrath S, Silverberg JI
Phenotypic differences of atopic dermatitis stratified by age.
Atopic dermatitis (AD) is a prevalent condition affecting individuals of all age groups. A deeper understanding of the diverse age-related phenotypes can enhance AD treatment strategies. The purpose of this study was to identify clinical phenotypes of AD associated with different age groups. A prospective study involving 380 participants was conducted in a dermatology practice setting. AD severity was assessed through questionnaires and comprehensive physical examinations. The study included 23 (6.1%) pediatric patients (<18 years), 176 (46.3%) young adults (18-39 years), and 181 (47.6%) older adults (≥ 40 years). The study found that both young and older adults displayed a lower likelihood of AD on the ankles, moderate to severe AD on flexures, pityriasis alba, weeping lesions, moderate to severe excoriations, and intense itching in comparison to pediatric patients. Young adults had more AD around the eyes. Older adults exhibited increased AD on elbows, nipples, knees, keratosis pilaris, and lichenification. Four distinct classes were identified regarding AD distribution and related signs.
AHRQ-funded; HS023011
Citation: Chatrath S, Silverberg JI .
Phenotypic differences of atopic dermatitis stratified by age.
JAAD Int 2023 Jun;11:1-7. doi: 10.1016/j.jdin.2022.08.026.
Keywords: Skin Conditions
Fishbein AB, Lor J, Penedo FJ
Patient-reported outcomes for measuring sleep disturbance in pediatric atopic dermatitis: cross-sectional study of the patient reported outcomes measurement information system pediatric sleep measures and actigraphy.
The purposes of this cross-sectional study were to test the Patient-Reported Outcomes Measurement Information System (PROMIS) sleep measures in pediatric atopic dermatitis (AD) and to develop an algorithm to screen, evaluate, and intervene to reduce sleep disturbances. Participants were children with AD aged 5 to 17 and one parent who completed sleep, itch, and AD-specific questionnaires. Clinicians assessed disease severity. PROMIS sleep disturbance parent proxy reliability was high and was differentiated among Patient-Oriented Eczema Measure (POEM)-determined disease severity groups. The authors concluded that sleep disturbance in pediatric AD should be screened using the POEM sleep question, and further assessment using the PROMIS sleep disturbance measure or objective sleep monitoring if it is needed.
AHRQ-funded; HS023011.
Citation: Fishbein AB, Lor J, Penedo FJ .
Patient-reported outcomes for measuring sleep disturbance in pediatric atopic dermatitis: cross-sectional study of the patient reported outcomes measurement information system pediatric sleep measures and actigraphy.
J Am Acad Dermatol 2023 Feb; 88(2):348-56. doi: 10.1016/j.jaad.2020.05.138..
Keywords: Children/Adolescents, Sleep Problems, Skin Conditions, Patient-Centered Outcomes Research, Evidence-Based Practice
Wurcel AG, Essien UR, Ortiz C
Variation by race in antibiotics prescribed for hospitalized patients with skin and soft tissue infections.
This cohort study examined antibiotics prescribed and variations by race among hospitalized patients with skin and soft tissue infections (SSTIs). A subanalysis of multisite, cross-sectional data collected through a national survey of acute care hospital groups within Vizient, Inc. considering adult inpatients treated for SSTIs was used. Of the 1242 adult inpatients included from 91 US hospitals, 45% were female, 18% were Black, and 69% were White with a mean age of 58 years. Penicillin allergy with hives was found in 23%, 19% with rash, and 18% with unknown effects, with allergy found more frequent in Black patients (23%) versus White (18%). Adjusting for multiple factors, White inpatients were at an increased risk of cefazolin use and decreased risk of clindamycin use compared with Black inpatients. Cefazolin use with less likely to be prescribed to Black inpatients than White inpatients and they were likely to be prescribed clindamycin. Cefazolin is considered a first-line SSTI treatment with clindamycin not recommended given frequent dosing and high potential for adverse effects including Clostridioides difficile infection (CDI). Although penicillin allergy is described as more prevalent among White patients, the authors observed an increased prevalence among Black inpatients compared with White inpatients treated for SSTI.
Citation: Wurcel AG, Essien UR, Ortiz C .
Variation by race in antibiotics prescribed for hospitalized patients with skin and soft tissue infections.
JAMA Netw Open 2021 Dec;4(12):e2140798. doi: 10.1001/jamanetworkopen.2021.40798..
Keywords: Antibiotics, Skin Conditions, Racial and Ethnic Minorities, Practice Patterns, Medication
Soper NS, Appukutty AJ, Paje D
Antibiotic overuse after discharge from medical short-stay units.
This study investigated antibiotic overuse after discharge from medical short-stay units (SSUs). This cross-sectional study included patients hospitalized in 2 different medical SSUs with a total of 40 beds at a single academic medical center. Eligible adults were discharged with an oral antibiotic from either SSU from May 2018 to September 2019. Of 100 patients discharged from SSUs with antibiotics, 47 had a skin and soft-tissue infection (SSTI), 22 pneumonia, 21 UTI, and 10 had “other” infections. Overall, 78 cases (78%) were defined as overuse, including 39 of 47 of those treated for SSTI, 17 of 21 for UTI, and 14 of 22 for pneumonia. The most common types of overuse were excess duration and guideline discordant selection. Examples of factors influencing overuse included consultant recommendations, miscalculation of duration, and the need for source control procedure.
AHRQ-funded; HS026530.
Citation: Soper NS, Appukutty AJ, Paje D .
Antibiotic overuse after discharge from medical short-stay units.
Nov;43(11):1689-92. doi: 10.1017/ice.2021.346..
Keywords: Antibiotics, Antimicrobial Stewardship, Medication, Pneumonia, Skin Conditions, Urinary Tract Infection (UTI), Respiratory Conditions, Hospital Discharge
Chovatiya R, Silverberg JI
Iatrogenic burden of atopic dermatitis.
The purpose of this study was to characterize the iatrogenic burden of atopic dermatitis (AD) and conduct a qualitative review of key areas that clinicians can address to minimize that burden. The researchers concluded that the multidimensional nature of AD requires a dynamic approach, and researcher recommendations included: encouraging providers to think strategically about the avoidance of itch triggers, slowly incorporating lifestyle changes, and highlighting step-up therapy when trigger avoidance becomes too burdensome for the patient. Out-of-pocket treatment costs should be incorporated into shared decision, polypharmacy should be minimized, and providers should incorporate evidence-based guidelines into their practices.
AHRQ-funded; HS026385.
Citation: Chovatiya R, Silverberg JI .
Iatrogenic burden of atopic dermatitis.
Dermatitis 2022 Nov-Dec;33(6s):S17-s23. doi: 10.1097/der.0000000000000799..
Keywords: Skin Conditions, Quality of Life
Chovatiya R, Begolka WS, Thibau IJ, R, Begolka WS, Thibau IJ
Impact and associations of atopic dermatitis out-of-pocket health care expenses in the United States.
The purpose of this study was to describe the impact and associations of out of pocket (OOP) health care expenses for atopic dermatitis (AD). The researchers administered a 25-question online survey to 113,502 National Eczema Association members aged 18 years or older. The study found that respondents with monthly OOP expenses over $200 were more likely to have increased AD severity, flares, health care provider visits, prescription polypharmacy, use of step-up therapy, frequent skin infections, and poorer disease control. Respondents with OOP yearly expenditures greater than $1000 had similar associations and additionally increased rates of comorbid asthma, allergic rhinitis, and anxiety/depression. A total of 64.6% of participants reported a harmful household financial impact of OOP expenses. Predictors of harmful impact included severe AD, comorbid asthma, 5 health care provider visits or more in a year, greater than $200 OOP monthly expenditures, and $1000 annual OOP expenditures or more. The study concluded that OOP expenses for AD are associated with increased disease severity and health care utilization and significantly impact household finances.
AHRQ-funded; HS026385.
Citation: Chovatiya R, Begolka WS, Thibau IJ, R, Begolka WS, Thibau IJ .
Impact and associations of atopic dermatitis out-of-pocket health care expenses in the United States.
Dermatitis 2022 Nov-Dec;33(6s):S43-S51. doi: 10.1097/der.0000000000000795..
Keywords: Skin Conditions, Healthcare Costs
Chovatiya R, Begolka WS, Thibau IJ
Financial burden and impact of atopic dermatitis out-of-pocket healthcare expenses among Black individuals in the United States.
The purpose of this study was to explain the categories and impact of out-of-pocket (OOP) healthcare expenses associated with atopic dermatitis (AD) management among black individuals. The researchers administered a voluntary online survey to 113, 502 members of the National Eczema Association. 77.3% of respondents met the participation criteria of being U.S. residents, 18 years of age and older, and self-reporting that they had AD or were the primary caregivers of individuals with AD. The study found that Blacks (74.2%) vs. non-Blacks (63.3%) reported more OOP costs for prescription medications covered (65.1%) and not covered (46.5%), by insurance, emergency room visits (22.1% vs. 11.8%), and outpatient laboratory testing (33.3% vs. 21.8%,). There was a relationship between Black race and increased household financial impact from OOP expenses, and predictors of financial impact included minimally controlled AD, systemic therapy, greater than $200 monthly OOP expenses, and Medicaid. Blacks with Medicaid had greater odds of harmful financial impact than those of black race or with Medicaid alone. The researchers concluded that there is a relationship between Black race increased OOP costs for AD, with significant financial impact to the household.
AHRQ-funded; HS026385.
Citation: Chovatiya R, Begolka WS, Thibau IJ .
Financial burden and impact of atopic dermatitis out-of-pocket healthcare expenses among Black individuals in the United States.
Arch Dermatol Res 2022 Oct;314(8):739-47. doi: 10.1007/s00403-021-02282-3..
Keywords: Skin Conditions, Healthcare Costs, Racial and Ethnic Minorities
Chovatiya R, Silverberg JI
Describe-ad: a novel classification framework for atopic dermatitis.
The purpose of this study was to develop a framework to standardize atopic dermatitis assessments based on a literature review and clinical experience. The researchers developed the DESCRIBE-AD framework to include both patient- and clinician-reported perspectives to effectively capture the clinical domains contributing to AD heterogeneity. DESCRIBE-AD includes assessments of Dermatitis morphology and phenotype, Evolution of disease, Symptom severity, Comorbid health disorders, Response to therapy, Intensity of lesions, Burden of disease, and Extent of lesions. The researchers conclude that DESCRIBE-AD can be utilized to better assess AD and guide treatment choices.
AHRQ-funded; HS026385.
Citation: Chovatiya R, Silverberg JI .
Describe-ad: a novel classification framework for atopic dermatitis.
J Am Acad Dermatol 2022 Sep;87(3):541-50. doi: 10.1016/j.jaad.2021.10.058..
Keywords: Skin Conditions
Chovatiya R, Silverberg JI
Evaluating the longitudinal course of atopic dermatitis: a review of the literature.
The purpose of this study was to better understand the longitudinal course of atopic dermatitis (AD) to improve clinical phenotyping and prognostication and improve personalized therapy recommendations. The researchers conducted a systematic literature review and meta-analysis of 46 studies to examine the current understanding of AD patterns over time and beyond childhood. The study found that 80% of childhood AD did not persist by 8 years of age and 5% by 20 years of age. Clinician-assessed severity showed a weaker association with persistence than patient-assessed severity. Persistent AD was related with intrinsic factors (severity, genetics, and atopic multimorbidity) and extrinsic (non-White race, Hispanic ethnicity, urban environment, and low income) factors. The researchers concluded that recognizing and incorporating the longitudinal course of AD is relevant for improved decision making in clinical practice and trials, and that future research should focus on the standardization of longitudinal course measures and their implementation alongside currently used measures for patient stratification and treatment.
AHRQ-funded; HS026385.
Citation: Chovatiya R, Silverberg JI .
Evaluating the longitudinal course of atopic dermatitis: a review of the literature.
J Am Acad Dermatol 2022 Sep;87(3):688-89. doi: 10.1016/j.jaad.2022.02.005..
Keywords: Skin Conditions
Manjunath J, Silverberg JI
Association of sleep disturbances with geriatric age in atopic dermatitis patients.
The purpose of this cross-sectional study was to investigate the association of geriatric age with atopic dermatitis (AD) severity and sleep disturbances (SD). Patients over the age of 18 seen at an eczema clinic were recruited and completed a self-administered questionnaire for encounters between 2014 and 2019. AD severity was assessed using the patient-oriented eczema measure (POEM), eczema area and severity index, Scoring AD (SCORAD), SCORAD-itch, investigator global assessment, and patient global assessment. The frequency of SD due to eczema was assessed using POEM. The impact of itching on the activity of falling asleep was assessed using 5 dimensions (5D) of itch. Fatigue was assessed using the patient-reported outcome measurement information system (PROMIS)-global health. Difficulty sleeping, falling asleep, and staying asleep was assessed using PROMIS-SD. The study found that geriatric AD patients had more profound SD, particularly staying asleep and fatigue, despite having AD severity similar to younger adult AD patients. The researchers concluded that future research is needed to understand why there is a difference between geriatric and non-geriatric patients as related to increased itching from atopic dermatitis and sleep disorders.
AHRQ-funded; HS023011.
Citation: Manjunath J, Silverberg JI .
Association of sleep disturbances with geriatric age in atopic dermatitis patients.
J Am Acad Dermatol 2022 Jul;87(1):206-08. doi: 10.1016/j.jaad.2021.07.039..
Keywords: Elderly, Sleep Problems, Skin Conditions
Cheng BT, Patel MS, Xu M
Timing of itch among children with atopic dermatitis.
The purpose of this study was to test the hypothesis that pediatric patients experience greater nighttime itch in atopic dermatitis. The primary study outcome was time of worst itch by parent report. Parents were asked “Over the past 7 days, what time of day or night was your child’s itch the worst?” They were able to select the hour of worst itch, with separate questions for weekdays versus weekend. Parents also rated their child’s itch intensity (range, 0-10; 10 = worst) during the morning, afternoon, evening, bedtime, and sleep. Data on when the child tried to sleep and how long it took to fall asleep were used to calculate time of sleep onset. Similarly, children ages 8 to 17 years were independently asked to self-report on time of worst itch, itch intensity at different times of day, and time of sleep onset. The researchers analyzed 240 parent-child dyads, with parent-proxy reported data from 60 infants (1-4 years), 120 children (5-12 years), and 60 adolescents (13-17 years) with AD and child self-reported data from all the children aged 8 to 17 years (n = 133). Most often, parent-proxy reported worst itch occurred at 7:00 PM during weekdays and 8:00 PM during weekends. Parents of older children aged 8 to 17 years old also reported worst itch at 7:00 PM during weekdays and 8:00 PM during weekends. Time of worst itch was consistent across age groups but delayed slightly as children grew older, likely owing to later bedtime. Parents of infants reported worst itch most frequently at 6:00 PM and 7:00 PM, children at 7:00 PM, and adolescents at 7:00 PM, 8:00 PM, and 10:00 PM. The researchers conclude that itch intensity by time of day might be explained by differences in skin and inflammatory circadian rhythms in childhood AD. Alternatively, evening rituals such as bathing, use of hot water and soap, and changing clothes may trigger itch. It also may be that children have more activities during the day to distract them from itch.
AHRQ-funded; HS023011.
Citation: Cheng BT, Patel MS, Xu M .
Timing of itch among children with atopic dermatitis.
Ann Allergy Asthma Immunol 2022 May;128(5):603-05. doi: 10.1016/j.anai.2022.01.042..
Keywords: Children/Adolescents, Skin Conditions
Cheng BT, Paller AS, Griffith JW
Burden and characteristics of skin pain among children with atopic dermatitis.
The purpose of this study was to determine clinical features and quality-of-life (QOL) burden associated with atopic dermatitis (AD)- induced skin pain in children. The researchers conducted a national cross-sectional survey of child-parent dyads with AD. Questions were administered to the parent proxy for all participants, and children 8 years and older completed a similar questionnaire adapted for self-report. The researchers surveyed 240 children with AD and parent dyads, including 60 infants (1-4 years) and 180 children (5-17 years). This cohort included 200 (83%) with moderate to very severe disease. The study reported that 111 of 240 participants (46%) had parent-proxy reported skin pain, and 59 of 133 children (44%) aged 8 to 17 years had self-reported skin pain. Children self-reported slightly greater pain intensity than did their parents. Pain intensity was associated with clinical skin features of bleeding, weeping/ oozing, cracking, itch frequency, and itch severity. Quality of life scores were also analyzed, with results indicating that skin pain was a significant factor in lower quality of life scores. The researchers concluded that intensity of skin pain in children was associated with significant decreases in quality of life.
AHRQ-funded; HS023011.
Citation: Cheng BT, Paller AS, Griffith JW .
Burden and characteristics of skin pain among children with atopic dermatitis.
J Allergy Clin Immunol Pract 2022 Apr;10(4):1104-06.e1. doi: 10.1016/j.jaip.2021.12.012..
Keywords: Children/Adolescents, Skin Conditions, Pain
Hong MR, Lei D, Yousaf M
A real-world study of the longitudinal course of itch severity and frequency in adults with atopic dermatitis.
A prospective, dermatology practice-based study was performed of adults with atopic dermatitis. Using a Numeric Rating Scale (NRS), regression models were constructed to examine itch over time. In repeated-measures regression models, persistent NRS average-itch scores were associated with baseline NRS average-itch and food allergy. Persistent NRS worst-itch was associated with baseline worst-itch NRS and Medicaid insurance. Patients with atopic dermatitis had a heterogeneous longitudinal course with fluctuating and complex overlapping patterns of average- and worst-itch intensity, and frequency.
AHRQ-funded; HS023011.
Citation: Hong MR, Lei D, Yousaf M .
A real-world study of the longitudinal course of itch severity and frequency in adults with atopic dermatitis.
Arch Dermatol Res 2022 Mar;314(2):141-49. doi: 10.1007/s00403-021-02214-1..
Keywords: Skin Conditions
Schwartzman G, Lei D, Ahmed A
Longitudinal course and phenotypes of health-related quality of life in adults with atopic dermatitis.
The real-world course of health-related quality of life (HRQoL) in atopic dermatitis (AD) is not well established. The aim of this prospective dermatology-practice based study was to examine predictors, longitudinal course and phenotypes of HRQoL in adult patients with AD. The investigators concluded that: patients with AD had a heterogeneous longitudinal course and distinct patterns of HRQoL; many patients had fluctuating HRQoL over time; and most patients with moderate to severe disease at baseline had persistent HRQoL impairment over time.
AHRQ-funded; HS023011.
Citation: Schwartzman G, Lei D, Ahmed A .
Longitudinal course and phenotypes of health-related quality of life in adults with atopic dermatitis.
Clin Exp Dermatol 2022 Feb;47(2):359-72. doi: 10.1111/ced.14948..
Keywords: Skin Conditions, Quality of Life
Zhou NY, Nili A, Blackwell CK
Parent report of sleep health and attention regulation in a cross-sectional study of infants and preschool-aged children with atopic dermatitis.
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. In this study the investigators aimed to characterize sleep and attention problems in young children with AD and identify modifiable factors. The investigators concluded that more severe AD correlates with poor sleep health and attention dysregulation.
AHRQ-funded; HS023011.
Citation: Zhou NY, Nili A, Blackwell CK .
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 Jan;39(1):61-68. doi: 10.1111/pde.14889..
Keywords: Children/Adolescents, Newborns/Infants, Sleep Problems, Skin Conditions
Hogan PG, Parrish KL, Mork RL
HOME2 study: household versus personalized decolonization in households of children with methicillin-resistant staphylococcus aureus skin and soft tissue infection-a randomized clinical trial.
This study’s goal was to compare the effectiveness of colonization measures to prevent skin and soft tissue infection (SSTI) from Methicillin-resistant Staphylococcus aureus (MRSA) with targeted household members with prior years SSTI to decolonizing all household members to prevent infections in children. The hypothesis was that the former method would be noninferior. Upon completion of the 12-month observational Household Observation of Methicillin-resistant Staphylococcus aureus in the Environment (HOME) study, 102 households were enrolled with the follow-up HOME2 study, a 12-month randomized noninferiority trial. Households were randomized 1:1 to the personalized (targeted members) or household (all members) approaches. Participants followed a 5-day regimen of hygiene education, twice-daily intranasal mupirocin, and daily bleach-water baths. At 5 follow-up visits at participants’ homes, swabs were taken to detect S. aureus. Noninferiority of the personalized approach was established, with little difference in SSTI rates in the two household approaches.
AHRQ-funded; HS021736; HS024269.
Citation: Hogan PG, Parrish KL, Mork RL .
HOME2 study: household versus personalized decolonization in households of children with methicillin-resistant staphylococcus aureus skin and soft tissue infection-a randomized clinical trial.
Clin Infect Dis 2021 Dec 6;73(11):e4568-e77. doi: 10.1093/cid/ciaa752..
Keywords: Children/Adolescents, Methicillin-Resistant Staphylococcus aureus (MRSA), Skin Conditions, Prevention
Chovatiya R, Silverberg JI
Association of herpes zoster and chronic inflammatory skin disease in US inpatients.
The purpose of this study was to determine whether chronic inflammatory skin disease (CISD) is associated with herpes zoster (HZ). Data from the Nationwide Inpatient Sample 2002-2012 were analyzed. Findings showed that many CISDs are associated with increased hospitalization for HZ, even below the ages recommended for HZ vaccination. Recommendations included additional studies to establish CISD-specific vaccination guidelines.
AHRQ-funded; HS023011.
Citation: Chovatiya R, Silverberg JI .
Association of herpes zoster and chronic inflammatory skin disease in US inpatients.
J Am Acad Dermatol 2021 Dec;85(6):1437-45. doi: 10.1016/j.jaad.2019.12.073..
Keywords: Healthcare Cost and Utilization Project (HCUP), Skin Conditions, Chronic Conditions
Silverberg JI
Validity and reliability of a novel numeric rating scale to measure skin-pain in adults with atopic dermatitis.
Little is known about the measurement properties of numeric rating scales (NRS) for pain in AD. In this study, the investigators evaluated a novel NRS for skin-pain and existing NRS for average overall-pain in adults with AD. Self-administered questionnaires and skin-examination were performed in 463 AD patients (age 18-97 years) in a dermatology practice setting.
AHRQ-funded; HS023011.
Citation: Silverberg JI .
Validity and reliability of a novel numeric rating scale to measure skin-pain in adults with atopic dermatitis.
Arch Dermatol Res 2021 Dec;313(10):855-61. doi: 10.1007/s00403-021-02185-3..
Keywords: Skin Conditions, Pain, Quality of Life
Cheng BT, Fishbein AB, Silverberg JI
Mental health symptoms and functional impairment in children with atopic dermatitis.
This study sought to determine the prevalence and predictors of social and behavioral symptoms and functional impairment among US children with atopic dermatitis (AD). Using MEPS data 1996-2015, findings showed that AD was associated with behavioral and functional impairment, similar to psoriasis and other common chronic conditions.
AHRQ-funded; HS023011.
Citation: Cheng BT, Fishbein AB, Silverberg JI .
Mental health symptoms and functional impairment in children with atopic dermatitis.
Dermatitis 2021 Sep-Oct;32(5):353-61. doi: 10.1097/der.0000000000000680..
Keywords: Children/Adolescents, Skin Conditions, Chronic Conditions, Behavioral Health
Fishbein AB, Lin B, Beaumont J
Nocturnal movements in children with atopic dermatitis have a timing pattern: a case-control study.
This case-control study compared nocturnal movements in children with atopic dermatitis (AD) with a control non-AD group. The study looked at nocturnal motor activity due to itch in children age 6 to 17 years with moderate-to-severe AD. The mean age of children with AD was 11.0 plus or minus 3.2 years, and without AD 11.5 plus or minute 3.3 years with the majority (65%) male. The AD scoring scale SCORAD was used to define moderate to severe AD. A home activity monitor, actigraphy and a sleep diary for 3 to 7 nights was used to monitor nocturnal movements and sleep. Activity counts were averaged across nights. Bouts of nocturnal activity increased in children with AD versus the controls between 1 and 6 hours after sleep onset. Nocturnal scratch activity peaks at 3 hours. Although AD patients were instructed to avoid oral antihistamine during the study, 5 patients took an antihistamine on some nights. Results showed no significant difference with respect to movement in the patients that took antihistamine some nights and not others. Timing of the nocturnal scratch behavior could potentially be targeted for treatment.
AHRQ-funded; HS023011.
Citation: Fishbein AB, Lin B, Beaumont J .
Nocturnal movements in children with atopic dermatitis have a timing pattern: a case-control study.
J Am Acad Dermatol 2021 Aug;85(2):474-76. doi: 10.1016/j.jaad.2018.04.020..
Keywords: Children/Adolescents, Skin Conditions, Chronic Conditions