Pediatric Skin Diseases Have High Quality of Life Impact

By Jancin, Bruce | Clinical Psychiatry News, June 2007 | Go to article overview

Pediatric Skin Diseases Have High Quality of Life Impact


Jancin, Bruce, Clinical Psychiatry News


MAUI, HAWAII -- The major chronic skin diseases of childhood impair quality of life to at least as great a degree as diabetes, renal disease, asthma, and other chronic nondermatologic diseases, Dr. Sarah L. Chamlin said at the annual Hawaii Dermatology Seminar sponsored by Skin Disease Education Foundation.

"Our diseases are actually as important in terms of quality of life as other diseases which have mortality associated with them," stressed Dr. Chamlin, a pediatric dermatologist at Children's Memorial Hospital, Chicago.

She cited a study conducted at Ninewells Hospital in Dundee, Scotland, in which investigators used standardized measures of pediatric health-related quality of life (QOL) to assess 379 children aged 5-16 years with skin diseases of more than 6 months' duration and 161 others with chronic nondermatologic diseases from both the childrens' and parents' perspectives.

The greatest adverse QOL impact occurred in children with cerebral palsy. Not far behind was generalized atopic dermatitis (AD), which impaired QOL to the same degree as renal disease and cystic fibrosis. The next tier in terms of QOL impact was occupied by psoriasis, urticaria, and asthma, which were all rated as having a greater negative impact than were epilepsy and enuresis. After that came diabetes, alopecia, localized eczema, and acne (Br. J. Dermatol. 2006;155:145-51).

"I was surprised acne didn't score higher," Dr. Chamlin commented. She noted that the teenage years are a critical time in terms of formation of self-image. Studies have shown that teens with acne tend to be socially withdrawn, have low self-esteem, and have more behavioral and emotional difficulties than do controls.

Not only does acne cause stress and anxiety, but stress and anxiety worsen acne severity, as was shown in a study involving 22 students at Stanford (Calif.) University. Their acne severity and emotional stress scores were significantly higher during exams than 1 month before. …

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