SCORAD and DLQI association in adult patients with atopic dermatitis in Kaunas Clinics, Lithuania

Abstract

Introduction Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by recurrent eczematous lesions and pruritus. The intense itching and rash can be bothersome and decrease a patient’s quality of life [1]. The impact of AD can be evaluated by the Dermatology Quality Life Index (DLQI) [2]. The Scoring of AD (SCORAD) index is a composite score that measures the activity and burden of the disease by evaluating both objective and subjective symptoms and the impact on quality of life [3]. Aim To evaluate and determine the association between the severity of AD and DLQI in adult patients with atopic dermatitis. Methods A case-control study was performed in the Skin and Venereal Diseases Clinic, Kaunas Clinics, Lithuania (bioethics approval 2020-07-15 Nr. BE-2-74). This study focused on the case group. The sample consisted of 32 patients with AD of Caucasian origin, aged between 18 – 56 years. The diagnosis of AD was confirmed by the Hanifin Raika criteria and evaluated by trained dermatologists. AD was grouped into a mild (<25), moderate (≥25), and severe (>50) phenotype as defined by SCORAD [4]. Quality of life was assessed using DLQI, which has been divided into 5 categories: no impairment of quality of life (0–1), mild impairment (2–5), moderate (6–10), severe (11–20) and very severe impairment (21–30) [5]. Height and weight for body mass index(BMI) were measured. We used the BMI classification by the World Health Organization (WHO) and assembled all participants into 4 groups: underweight (BMI <18.5 kg/m2), normal (BMI18.5–24.9 kg/m2), overweight (25-29.9 kg/m2) and obesity (>30.0 kg/m2) [6]. Statistical data analysis was performed using the SPSS program. Spearman’s correlation coefficient was used to evaluate the correlation. In this abstract, we will present the demographic data of the case group and the association between SCORAD and DLQI. Results 32 subjects with a mean ± SD age 32 ± 10.43 were enrolled in the study. 65.5% of patients were women (n=21) and 34.4% were men (n=11). Among all participants, the mean BMI in women was 23.23 ± 4.32 and 24.04 ± 2.67 in men. 23 (71.9%) patients had a normal BMI, 1 (3.1%) female patient had too low BMI, 4 (12.5%) patients were overweight, and 4 (12.5%) had first-degree obesity. The mean SCORAD – 34.22 ± 18.86. According to SCORAD, 13 (40.6%) patients had mild AD (3 men and 10 women), 13 (40.6%) had moderate AD (5 men and 8 women), 6 (18.8%) had severe AD (3 men and 3 women). The DLQI scores ranged from 0 to 28 (median=8). SCORAD and DLQI were moderately but significantly correlated (Spearman's ρ = 0.742, p <0.001). Out of 13 patients diagnosed with mild AD, 4 (30.8%) had no impairment in their life, 4 (30.8%) had mild impairment, and 5 (38.5%) – moderate. Of the 13 patients diagnosed with moderate AD, 15.4% (n=2) had a mild impairment, 30.8% (n=4) had a moderate impairment,38.5% (n=5) had a severe impairment, and 15.4% (n=2) had a very severe impairment, as assessed using the DLQI. 6 patients were diagnosed with severe AD. Of these, 33.3% (n=2) had a moderate impairment, 33.3% (n=2) had a severe impairment, and 33.3% (n=2) had a very severe impairment of quality of life. Conclusions This study represents the first study in the Baltics to determine SCORAD and DLQI associations in adult patients with AD. Assessing the data of adult patients with AD, it is apparent that higher AD severity is associated with a poorer DLQI score.