Reviewing Atopic Dermatitis Prevalence, Disease Severity's Impact on Patients

Raj Chovatiya, MD, PhD, director, Center for Eczema and Itch, Northwestern University, shares how severe atopic dermatitis impacts patients' quality of life, as well as what treatment challenges exist for this patient population.

Read the full transcript:

Welcome back to PopHealth Perspectives, a conversation with the Population Health Learning Network where we combine expert commentary and exclusive insight into key issues in population health management, and more.

On today's episode, Dr Raj Chovatiya offers insight into the challenges of treating severe atopic dermatitis.

Hi there. My name is Dr Raj Chovatiya. I'm an assistant professor of dermatology and director of the Center for Eczema and Itch at the Northwestern University Feinberg School of Medicine in Chicago, Illinois.

Can you discuss the prevalence and burden of atopic dermatitis in the United States?

Sure. If you practice dermatology, you are going to see atopic dermatitis on a very regular and routine basis, just because it's so darn common. We know it's probably the most common chronic inflammatory skin disease that we see. There have been a lot of great population-based studies over the past decade that try to nail this number down.

In the United States, the overall prevalence across age groups is estimated around 10%, which is kind of crazy. When you take a step back and think about it, 1 in every 10 people at some point have atopic dermatitis. And when you separate children and adults, around 13% of kids and 7% of adults have atopic dermatitis in the United States.

The prevalence speaks to how common the disease is, but the actual burden associated with the disease is huge as well, from individual, family, societal, and health care perspectives. When you add those 2 features together, there’s a reason why atopic dermatitis is a disease we need to be talking and caring about more.

How does disease severity impact patients' quality of life and productivity at work and school?

With atopic dermatitis, there are a lot of ways to think about disease severity.

There's obviously the severity you can see on the skin, in terms of the signs of inflammation. There's severity associated with symptom burden. There can also be severity associated with the comorbidities associated with the disease, and some of the quality-of-life aspects.

No matter which way you skin it, with increasing severity of disease, you're looking at increased burden to both the patient and the health care system, and greater impact on day-to-day life. We know that as disease severity increases, and as atopic dermatitis goes untreated, there are definite decreases in work productivity and normal activity.

In fact, routine activity is quite impaired, and this has a big effect on direct and indirect costs as well.

What challenges do clinicians typically face when treating patients with severe disease?

The obvious answer would be there's been a lack of targeted, safe treatments for people with severe disease for a long time. Recently, we're in the midst of a revolution where we're starting to have options for these patients. But for people with severe disease, there has been a lack of treatments which they feel comfortable receiving long term, which clear their skin, and which control their symptoms well in the long run. That's 1 challenge.

Other challenges include access to therapy. Many people who have the most severe disease are oftentimes not the ones that have the most resources to deal with health issues. Being able to get their hands on a good treatment that's going to work is important.

But access goes beyond just the treatments, including access in general to health care providers and dermatology specialists. This is another important aspect of the equation that becomes significant when we think about people with severe disease.

Thanks for tuning in to another episode of PopHealth Perspectives. For similar content, or to join our mailing list, visit populationhealthnet.com.

This transcript has been edited for clarity.