Multidimensional burden of atopic dermatitis in elderly patients with head, face and neck involvement: A real-world multicentre cross-sectional study

Background Atopic dermatitis (AD) is burdensome. AD with head, face and neck (HFN) involvement seems more strongly associated with quality-of-life impairment than other locations. Aim To investigate how HFN involvement affects the psychological and economic burden of AD in elderly population. Methods We evaluated elderly patients with AD using the eczema area and severity index (EASI), patient-oriented eczema measure (POEM), worst itch numerical rating scale (WI-NRS), dermatology life quality index (DLQI), and hospital anxiety and depression scale. Additionally, we collected data on annual direct medical costs to assess economic burden. Results A total of 3,066 elderly patients with AD were included in the study and 1375 (44.85%) patients had HFN involvement. Compared to patients without HFN involvement, patients with HFN involvement showed a greater proportion of hand, foot, breast and perianal/genital areas involvement and exhibited a higher prevalence of severe AD signs, severe AD symptoms, severe itching, moderate to severe anxiety, and moderate to severe depression, as well as annual direct medical cost. Limitations This study has several limitations; there is potential for selection and recall bias due to its reliance on data from tertiary hospitals and patient-reported outcomes, and statistical bias from using binary logistic regression rather than ordinal regression methods. Conclusion In this real-world study, HFN involvement had significant effects on clinical presentation and disease burden among elderly patients with AD. These findings could guide clinicians in formulating tailored treatment strategies and evaluating disease prognosis in elderly patients with AD.