Impact of Moderate-to-Severe Atopic Dermatitis on Daily Functioning among Adolescent Patients: A Real-World Study in the United States

Abstract

Background: Atopic dermatitis (AD) negatively impacts the daily lives of pediatric and adolescent patients, potentially leading to poor developmental and behavioral outcomes. Understanding the real-world disease burden and the impact of AD on the patients’ quality of life (QoL) after the introduction of new treatments for AD will help identify unmet clinical needs and approaches to improve the patients' QoL. Therefore, this study aims to understand the impact of AD on daily functioning in adolescent patients.

Methods: This analysis used data from the 2025 Adelphi Pediatric AD Wave II Disease Specific Programme, which links cross-sectional surveys with retrospective data from patient their consulting physicians in the United States. Primary care physicians/internal medicine specialists, dermatologists, pediatricians, and allergists reported clinical information, including current AD severity, using patient record forms. Adolescent patients with physician-reported moderate-to-severe AD at the date of consultation were included for this analysis. Patients self-reported the impact of AD on different areas of their daily life on a scale using ‘all the time’, ‘sometimes’, ‘rarely’, and ‘never’, with rarely and never combined. Descriptive analyses were conducted.

Results: Among 288 patients with moderate-to-severe AD, 24% (n=70) of patients self-reported the impact of AD. The patients had a mean (SD) age of 14.9 (1.5) years, with 47% female, and of those with known data (n=46) mean (SD) disease duration was 6.1 (5.3) years. Patients reported that due to their AD, they feel embarrassed (all the time: 24%; sometimes: 51%; rarely/never: 24%), self-conscious (all the time: 29%; sometimes: 44%; rarely/never: 27%), irritated or have mood swings (all the time: 9%; sometimes: 33%; rarely/never: 59%), anxious or constant worry (all the time: 13%; sometimes: 33%; rarely/never: 54%), and overwhelmed (all the time: 17%; sometimes: 22%; rarely/never: 61%). They also reported having low self-esteem (all the time: 16%; sometimes: 34%; rarely/never: 50%), difficulty in concentrating (all the time: 13%; sometimes: 20%; rarely/never: 67%), difficulty in relaxing (all the time: 11%; sometimes: 24%; rarely/never: 64%), and have low mood or feel depressed (all the time: 9%; sometimes: 29%; rarely/never: 63%).

Conclusion: These results highlight the profound impact of AD on daily life in adolescent patients with moderate-to-severe disease, with one-quarter of patients feeling embarrassed or self-conscious about their AD all the time. These disease-associated burdens occur during key developmental milestones and can impact the overall course of the patient’s life. Therefore, these findings emphasize the need to carefully assess and consider patients' QoL when discussing treatment options.