While for most adolescents, going back to school in presence is a source of joy, for some, however, the social distancing imposed by Covid-19 has represented a safe haven that is difficult and sometimes painful to give up. They are the boys who suffer from atopic dermatitis, a chronic inflammatory disease that affects the skin of the face and body. For them, relating to the rest of the world with a screen in the middle was potentially easier because the ‘signs’ of atopic dermatitis can be better disguised. To photograph the discomfort of adolescents (but also adults) suffering from this pathology was a research carried out by Doxa Pharma on behalf of Sanofi Genzyme with the aim of understanding the experiences of Italian patients with atopic dermatitis and the impact of the disease on personal, family, social, school and work spheres. An impact today also told through an animated series entitled ‘Dado and Adele: two friends for the skin’.
Atopic dermatitis of teenagers
Until recently, atopic dermatitis was considered a disease predominantly of children with a tendency to disappear with age. “Atopic dermatitis frequently begins in early childhood and progressively tends to improve with growth”, explains Gian Luigi Marseglia, director of UOC Pediatrics-Pediatric Clinic of the IRCCS Policlinico San Matteo-Pavia Foundation. “However, in a considerable percentage of cases estimated at around 7-10 percent of the age group between 12 and 18 years, the disease persists, inevitably dragging itself into adulthood. The disease in every age group is characterized by eczematous lesions which, depending on the age, prefer particular skin areas. The common symptom from the first years of life to adulthood is itching “.
Symptoms beyond the skin
In adolescence, the disease that has not subsided with growth, as a rule, becomes more tenacious: the lesions tend to take on a particular dryness and become more thickened and particularly itchy. The disease, however, is not limited to the skin. “In fact, it is very frequently associated with other clinical manifestations affecting other organs: for example bronchial asthma, allergic rhinitis, nasal polyposis as well as gastrointestinal manifestations”, continues Marseglia.
The impact on the quality of life
In adolescence, therefore, the disease becomes complicated with a heavy relapse on the quality of life of children: “Skin lesions – underlines Marseglia – have a negative impact on social relationships, isolated nocturnal itching or sometimes associated with a blocked nose due to rhinitis or nasal polyps is reflected on the quality of sleep and therefore once again on school performance and social life “. Additionally, teens can be bullied and disregarded by peers. “The suffering of adolescents suffering from atopic dermatitis – explains Ilaria Baiardini, psychologist and psychotherapist – does not derive only from the practical and emotional difficulties related to the disease and the way in which it is lived, but also from the painful episodes that the patient experiences in relationships with the others”.
Between embarrassment and symptoms on the body
Discomfort and suffering that clearly emerge from the Doxa Pharma survey, conducted on 200 patients aged 12 to 24 and 201 over 25. For 1 out of 2 patients, this disease has a highly negative impact on their quality of life. 91% of patients accuse symptoms in visible areas with a strong impact on the relational and psychological component.
Among the students interviewed, 66.5% said they self-isolate themselves due to the outward appearance that causes them the disease, a percentage that rises to 88% in patients between the ages of 12 and 15. One in three (over 50% in the 12-15 age group) also reported being bullied. A percentage that is found almost identical in the experiences of professional discrimination reported by 39.2% of the 183 workers interviewed. Overall, two out of three patients with atopic dermatitis (77.9% young people, 67.8% adults) attribute severe limitations to the disease in their daily and professional life. Furthermore, in those suffering from this pathology, the risk of anxiety and depression also increases.
The importance of treatment
Atopic dermatitis is not without a way out. “Today we have new therapeutic strategies based on the use of monoclonal antibodies which, like intelligent weapons, are able to selectively target the main biological mediators underlying the clinical manifestations of the disease”, explains Marseglia who is also president of the Italian Society of Allergology. and Pediatric Immunology (SIAIP). “I am referring to the cytokines IL 4 and IL 13 which constitute the switches which, once turned on, amplify all the inflammatory mechanisms responsible not only for the skin manifestations but also for the manifestations affecting the other organs”. These drugs are administered in specialized centers. “The results are extraordinary – continues the pediatrician. “In recent years, the management of patients with atopic dermatitis has been completely revolutionized in light of the new acquisitions in the therapeutic field”. In addition to this, the adolescent with atopic dermatitis must regularly take care of their skin which is constitutionally fragile using hygiene products and emollient creams recommended by their doctor.
‘Dado and Adele: two close friends’
To bring out the painful experience of the teenager with atopic dermatitis is the animated series ‘Die and Adele: two friends for the skin ‘made by Sanofi and available on the website “Dermatopia.it”. The series tells the life of two friends struggling with a disease with a strong physical, emotional and social impact, from adolescence to adulthood. It also collects a series of useful tips and information on how to better manage the discomforts dictated by the disease. The first three episodes are dedicated to the two protagonists in adolescence. Dado is 13 years old and has lived with atopic dermatitis since he was a child; Adele is 12 years old and a few months ago she started suffering from this pathology that causes her so much embarrassment and makes her sad. The two meet on the bus that takes them to school and become friends when Adele is teased by her classmates because of the spots and lesions on her skin. In short, a sympathy arises between them which then evolves from episode to episode and which reveals that there is still a stigma towards those suffering from certain pathologies.
“Recognizing and legitimizing the presence of emotional suffering – points out the psychologist Baiardini – represents the first step to feel better. A step that the patient sometimes takes independently and that leads him to go to a psychologist. But this does not always happen, both because of a lack of information on the psychological aspects related to physical pathologies, and because of a difficulty on the part of the doctor and the patient’s family, to discuss such personal and delicate aspects and to suggest that a specialist be consulted. “. Precisely for this reason being able to tell the discomforts of those suffering from a dermatological disease through the universal language of cartoons is an innovative way to reach all ages, starting with adolescents who are so difficult to interest and involve in ‘committed’ content. A message addressed not only to adolescent patients but also to their peers who are often unaware of the suffering they cause to a friend they make fun of.