The pandemic has exacerbated the disease in people with atopic dermatitis

Atopic dermatitis (AD) It is a common condition that mainly affects children, but can persist, come back or start in adulthood. In all cases, itching can lead to sleep deprivation and have a huge impact on quality of life. It is chronic or chronic recurrent inflammatory disease, which can have a wide range of presentations, and is mainly characterized by dry skin, severe itching and localized inflammatory skin lesions (eczema), which are considerably debilitating.

The Argentine Association of Atopic Dermatitis (ADAR) and the Civil Association of Patients with Psoriasis (AEPSO), two organizations that work to support and advise people with this disease and their families, have come together to achieve an investigation into the situation that patients have gone through (and are going through) since the COVID-19 pandemic, since March 2020; they inquired about quality of life, access to health, work situation, eating habits, physical activity and stress levels. They presented the results as part of the World Atopic Dermatitis Day, who is commemorated each September 14.

The survey, called “Evolution of patients with atopic dermatitis during the COVID-19 pandemic, was implemented online between the June 12 and July 8 of this year; they participated 535 patients from all over the country, with recruitment via social networks, WhatsApp groups and mailing from both organizations.

“We assume that this unfavorable context impacted -although in a different way- in all human beings, but that the obstacles could have been even more difficult for the community of people living with a chronic disease like this and in the context of our country. We set out to understand this reality in order to share the results later with health policy makers, ”he said. Silvia Fernandez Barrio, President of AEPSO.

Anxiety (52.9%), anxiety (43.2%), fatigue (40.4%) and burnout (39.6%) They were the main feelings that patients have about their illness during quarantine. “We have all experienced emotions like this throughout these 18 months, but the coexistence of a chronic disease worsens the situation, accentuating or enlarging other complications we face, ”he said. Mariana palacios, President of MARCH.

During the pandemic, 55% of patients rated their atopic dermatitis as moderate or severe and, compared to what they felt before March 2020, half of their illnesses worsened. Besides, for 62.8% the itching during quarantine was (and is) moderate or high, youn 41.3% more than before.

The the itching is not a minor aspect. People with chronically and severely itchy skin tThey are three times more likely to develop depression and twice as likely to experience anxiety. Other research had already shown that several times Mental health disorders in people with skin conditions are directly related to the level of itching.

Before quarantine, 62.1% were in treatment for their atopic dermatitis (especially with emollient or moisturizing creams and corticosteroid creams), but 18.1% had to stop it, usually for financial reasons and 1 in 10 decided -by his account- stop medication for fear of COVID-19.

“We also learned that cases were receiving systemic treatments, both older drugs and modern monoclonal antibodies, and suffered bureaucratic interruptions due to the closure of the offices of social and prepaid works. This has been reinstated, but it would give the impression that there are obstacles that are here to stay and we are concerned about the future of access to treatment for this type of chronic disease, ”he said. points out Fernandez Barrio.

But how to cure the disease? “In the first place, proper skin care, which includes instructions for bathing and the use of moisturizers. Besides, different topical treatment options for eczema lesions, and for cases refractory to the use of immunomodulators or new biological treatments which offer current prospects of hope, which will increase in view of the intense ongoing investigation, ”said Dr. Marta Patricia La Forgia, specialist in Dermatology, Allergy and Immunology (UBA), and director of the immunodermatology committee of the Argentinian Association of Allergy and Clinical Immunology (AAAeIC). Anyway, the most important thing always, It is receive a specialist consultation early. Timely and adequate care will enable patients to improve their quality of life.

The pandemic, as in the rest of the population, impacted on the workplace: 13% of patients lost their jobs compared to 7.1% who got one. “Having a chronic illness and changing jobs can be dramatic. First, to have to deal with unfounded stigmata that prevent you from being rehired, but then because, perhaps, the new job offers health coverage that does not cover certain benefits you need or the medical team treating you. It is cstart over, redo your medical history, re-manage treatment that has worked for you, with all the time and effort it takes, giving the disease several feet of advantage. In reality, 7.1% lost their health coverage in the pandemic ”, recognized Fernandez Barrio.

Among who had to be hospitalized for his dermatitis in this year and a half, which fortunately they were a minority (5.6%, although the percentage rises to 15.7% in children between 1 and 5 years old), 1 in 5 had trouble finding a bed. “Let’s put ourselves for a moment in the shoes of a family with a baby with a generalized relapse, that is, a body with eczema, infections, pain, itching and no possibility of going to a medical center for treatment. These are traumatic experiences that we never forget, ”he said. Palacios.

Of all respondents, 66.3% had scheduled checks in March 2020, corn only 3 in 10 were able to complete them and 38.5% did so by telemedicine (via WhatsApp 72.4% of the time). “The Technology have shown that this can be part of the solution of a complex problem that we have in Argentina, what is it lack of specialists (and equipment) in many cities across the country, which force the patient to travel long distances to receive medical care, ”he added. Palacios.

As explained by the doctor Paula luna, specialist in Dermatology and Dermatology of the Child of German hospital, “the face to face consultation is irreplaceable, corn teleconsultation would be a valid complement because these skin diseases can be followed by photos or a video call ”.

Since atopic dermatitis shares the underlying inflammatory process with other diseases, called “type 2 inflammation”, Moon stated that It’s no surprise that 7 in 10 participants have an environmental allergy (47.1%), Food allergy (20.2%), asthma (15.7%) and, to a lesser extent, polyposis, rhinoconjunctivitis and eosinophilic esophagitis.

More obesity, sedentary lifestyle and stress

On average, survey participants gained 2 kg during the pandemic and 10% gained more than 10 kg. Also physical activity decreased (60.6% don’t exercise, but of that total, 1 in 4 did so before the pandemic, gave up and hasn’t returned yet).

“We have to pay attention to these data, because being a systemic and inflammatory disease, its link with obesity and cardiovascular complications is under study, comorbidities that have already been widely demonstrated in other diseases such as psoriasis “, he precised Moon.

6 out of 10 patients consider their current stress level to be high or very high, 34% more than in the pre-pandemic world. On another side, 6 in 10 say their current sleep quality is fair or poor and for 37.8%, it got worse.

“During the start of quarantine many mental health treatments have been interrupted because the psychologists were not declared essential personnel and therefore we had to stop the treatments. For various reasons, many patients could not adapt to telemedicine, which made their situation even worse, ”he said. Laura Resnichenco, Graduated in psychology, member of MARCH.

Other survey results

– 1 of 4 patients with atopic dermatitis had COVID-19[FEMININE

– Les médias de masse (61,1%) et médecins (43,9 %) étaient les les sources d’information les plus consultées pour en savoir plus sur les vaccins.

– Presque 90% acceptent de se faire vacciner (lorsque l’enquête a été menée, 34,2 % l’avaient fait).

L’existence de la 10% restants, qui ne seraient pas vaccinés, Cela représente un signal d’alarme : « Il faudrait se renseigner sur les raisons, mais la vaccination sauve des millions de vies par an Et bien que les connaissances sur ce virus évoluent constamment, nous disposons aujourd’hui de preuves suffisantes que les vaccins contre le COVID-19 sont efficaces et sûrs. Si un patient a des doutes sur la commodité de se faire vacciner en raison du type de traitement qu’il reçoit, il peut consulter son médecin et très probablement il lui dira de le faire. Toujours il est important de maintenir un dialogue fluide et digne de confiance avec le professionnel de la santé qu’il soigne votre dermatite atopique », a conclu le spécialiste.

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