CLINICAL SEVERITY, QUALITY OF LIFE IMPACT, AND PREDICTORS OF SEVERE ATOPIC DERMATITIS IN PAEDIATRIC PATIENTS ATTENDING A TERTIARY DERMATOLOGY CLINIC: A CROSS-SECTIONAL STUDY USING SCORAD AND CDLQI
DOI:
https://doi.org/10.48047/pn998828Keywords:
atopic dermatitis, quality of life, disease severity, predictors, biologic therapyAbstract
Background: Atopic dermatitis (AD) is the most common chronic inflammatory skin disease in children, characterised by intense pruritus, sleep disturbance, and profound impairment of quality of life (QoL). Validated instruments—SCORAD for clinical severity and CDLQI for paediatric QoL—enable systematic assessment but are infrequently used in Indian tertiary care settings. This study evaluated disease severity, QoL impact, and predictors of severe AD in a paediatric cohort. Methods: A cross-sectional study enrolled 180 paediatric patients (aged 2–14 years) with physician-confirmed atopic dermatitis using modified UK Working Party criteria at a tertiary dermatology clinic. Disease severity was assessed using SCORAD (Scoring Atopic Dermatitis); QoL using CDLQI (Children's Dermatology Life Quality Index). Pearson correlation between SCORAD and CDLQI was determined. Multivariable logistic regression identified predictors of severe AD (SCORAD >40). Results: Mean SCORAD was 38 ± 16; 23.3% had severe AD (SCORAD >40). Mean CDLQI was 12.4 ± 6.2. SCORAD and CDLQI were strongly correlated (r=0.74; p<0.001). Severe AD patients had significantly worse CDLQI (18 ± 5 vs 8 ± 4; p<0.001), more sleep disruption (4.2 vs 1.8 nights/week), and more missed school days (4.8 vs 1.2 days/month). Independent predictors of severe AD: early onset <6 months (aOR 2.4), elevated IgE >500 IU/mL (aOR 2.2), family history of atopy (aOR 2.1), and comorbid asthma (aOR 1.9). Conclusion: Paediatric AD is associated with substantial QoL impairment strongly correlated with disease severity. Early-onset disease, elevated IgE, atopic family history, and asthma comorbidity predict severe disease. These findings argue for routine SCORAD and CDLQI administration in clinical practice, early specialist referral for high-risk profiles, and systematic QoL assessment to justify stepwise escalation of therapy including biologic agents
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