Adele has become a dynamic woman and has overcome the insecurities caused by her atopic dermatitis. She follows her daily hygiene routine and a balanced diet to keep inflammation at bay. Dado, on the other hand, is a little discouraged due to the stress that his new job is causing him and which is causing the symptoms of his dermatological disease to worsen. The two young adults are the protagonists of the animated series ‘Dado and Adele: two friends for the skin’ (available on the website www.dermatopia.it) twenty years after their first meeting at school. We see them in the episodes dedicated to atopic dermatitis in adults who have to live with this disease every day and with all the consequences that it entails including a reduction in work performance, absences from work or presentism, but also renunciations related to social life. A disease, atopic dermatitis, which, according to the data of a recent survey on Italian specialist centers (dermatological, allergological), affects over 35,000 adult patients followed in Italy, of which about 8,000 are affected by the severe form of the disease.
The impact on work and social life
To testify the impact that this pathology can have on adults is a study published in the Journal of Allergy and Clinical Immunology. Among adults suffering from moderate to severe atopic dermatitis, 38% report that the disease has an impact on social life and 34% also at work with negative consequences on productivity. Not only that: several studies have shown that patients with atopic dermatitis are more likely than healthy people to be unemployed, with significant social costs. A Doxa Pharma survey, conducted on 200 patients aged 12 to 24 and 201 over 25, also investigated the effects that this disease can have on work. One in three adults reports at least one episode of discrimination at work; 2 out of 3 feel that dermatitis has an impact on their work performance, also limiting their professional prospects. This translates – for 1 in 3 – into a tendency to be absent or unproductive for at least a few days each month. In fact, among workers with dermatitis there are almost 11 days of absences from work per year and 13 days of presentism, that is, the habit of going to work even in proven conditions of malaise.
Insomnia and depression
It happens because in the most severe forms of the disease, itchy lesions can cover most of the body, often accompanied by dryness, wounds and more intense itching. Symptoms that severely compromise the quality of life of patients, with sleep disturbances and an increase in symptoms of anxiety and depression. According to a recent study published in the Journal of the American Academy of Dermatology, in 86% of cases, patients with severe atopic dermatitis reported itching symptoms every day, 55% reported disturbed sleep for 5 or more days a week, for 44% their social and recreational life was impaired and more than 50% reported symptoms of depression and / or anxiety. In addition, due to sleep deprivation due to nocturnal itching, patients more frequently face accidents of various kinds or work-related injuries. In general, especially due to persistent itching, difficulty sleeping and obvious aesthetic problems, every daily activity is strongly compromised, even family or recreational ones.
The other diseases
To worsen the picture is also the fact that atopic dermatitis is often associated with other pathologies because it is not just a skin disease: the typical lesions on the skin, in fact, are only the visible manifestation of an underlying systemic inflammation. Furthermore, the ‘epidermal barrier defect’ is often only the starting point of what is called ‘atopic march’: the correlation, concomitance or subsequent onset of atopic pathologies. In fact, more than half of adult patients with moderate to severe atopic dermatitis also have another condition caused by type 2 inflammation such as chronic rhinosinusitis with or without nasal polyposis or eosinophilic esophagitis. In addition, 31% of those with moderate or severe atopic dermatitis also suffer from asthma.
A systemic pathology
Is it possible that a skin disease is able to trigger so many discomforts? “The fact is that this is a systemic disease and not only for respiratory comorbidities, such as respiratory and food allergies,” replies Anna Belloni Fortina, head of the Pediatric Dermatology Service of the University of Padua. “It is a disease that in the long run can lead to alterations of the cardiovascular system and metabolism, but until now it has been underestimated and perhaps only now we begin to know it better thanks to the new therapies that have allowed us to somehow make the rounds. on the contrary, that is, to better understand atopic dermatitis through drugs. Now we have understood that this is actually a disease to be taken seriously ”.
How many limits in everyday life
“Atopic dermatitis – continues Fortina – is extremely disabling for adults and can also have consequences on the choice of work because a patient who carries this disease with him since childhood knows well that, for example, he must avoid carrying out jobs in dusty or sweaty environments. So he has to make choices that take these aspects into account ”. And then there are the repercussions on social but also emotional relationships: “These patients – continues Fortina – have skin so heavily altered by dermatitis that they are unable to have good social relationships and sometimes not even romantic relationships. Indeed, sometimes the disease causes real shipwrecks of romantic relationships and I also have experiences of patients with adult-onset atopic dermatitis who separated from their partner precisely as a result of the fact that the management of the disease became unbearable within the couple”.
Improve access to new therapies
With the right daily hygiene routine and the care prescribed by the dermatologist, today atopic dermatitis can be treated and managed much better than in the past. “Thanks to the new drugs we have been able to identify patients who had somehow completely disappeared from our radars and this was an advantage but I am convinced as a doctor and researcher that there is still a long way to go, for example for the daily management of these patients who are currently completely dependent on them and is not a trivial management from an economic point of view “, notes the expert who adds:” For a person who has a basic salary it is almost impossible to manage it adequately and also as far as therapies are concerned, the problem always lies in the possibility of accessing the best care, especially for patients, who unfortunately are the vast majority of adults, who suffer from dermatitis in a moderate form because, for reasons of pharmaco-economy, entry to drugs more innovative is reserved only for the most serious forms. I hope that in the future there is the possibility of lowering this threshold of access by treating even the moderate forms since it still has heavy consequences on the lives of these patients “.