Self-perceived disease control in childhood eczema

Abstract

Background

Atopic eczema (AE) is a common relapsing inflammatory skin disease in children which is often associated with chronicity and poor quality of life. Unlike atopic asthma, control of AE is seldom assessed in therapeutics.

Aim

To investigate the utility of a Traffic Light Control (TLC) system as a measurement/assessment of self-perceived eczema control.

Methods

This is a prospectively study of all Chinese children (aged 6–18 years old) with eczema attending the pediatric dermatology clinic of a tertiary hospital from January to June 2020. Eczema control, eczema severity, quality of life and biophysical skin condition of consecutive patients at the pediatric dermatology clinic of a teaching hospital were evaluated with the validated Chinese versions of Depressive, Anxiety, Stress Scales (DASS-21), Patient Oriented Eczema Measure (POEM), transepidermal water loss (TEWL), and stratum corneum skin hydration (SH), respectively. With a visual TLC analogy, patients were asked if their eczema is under control (green light), worsening (yellow) or in flare-up (red light).

Results

Among AE patients (n = 36), self-perceived TLC as green (under control), amber (worsening) and red (flare up) reflected acute and chronic severity (SCORAD, NESS, POEM) and quality of life (CDLQI) (p < .0001), but not SH, TEWL or Depression, anxiety and stress.

Conclusions

Eczema control can be semi-quantified with a child-friendly TLC self-assessment system. AE patients reporting worse eczema control have worse acute and chronic eczema severity, more impairment of quality of life; but not the psychologic symptoms of depression, anxiety and stress or skin hydration or transepidermal water loss. TLC can be linked to an eczema action plan to guide patient management.

Keywords:

• Eczema
• quality of life
• self-awareness
• SCORAD
• Children

Author contributions

Lam PH is responsible for acquisition of data, analysis and interpretation of data and drafting of the manuscript. Hon KL is responsible for concept and design, drafting of the manuscript and critical revision for important intellectual content. Leong KF and Leung TF are responsible for critical revision for important intellectual content.

Disclosure statement

The authors declared no conflict of interest in this work. All authors edited and agreed to this manuscript of work.