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Multidisciplinary Management of Chronic Atopic Dermatitis in Children and Adolescents: A Prospective Pilot Study.

Research paper by Kylie K Leong, Thomas W Y TWY Ong, Yee-Wah YW Foong, Yen-Peng YP Wong, Winnie W Lim, Hui-Min HM Liew, Mark J A MJA Koh

Indexed on: 13 Jun '20Published on: 13 Jun '20Published in: The Journal of dermatological treatment



Abstract

Atopic dermatitis (AD) is a chronic, pruritic disorder affecting 10-20% of children and is associated with psychological issues and impaired quality of life (QoL). The role of psychosocial support in the treatment of AD is increasingly important. We studied the impact of a multidisciplinary clinic (MDC) in the management of AD in a tertiary children's hospital in Singapore. We performed a prospective pilot interventional study on 34 pediatric patients with AD and concomitant psychosocial impairment. Patients were recruited into an MDC, comprising a dermatologist, clinical psychologist and medical social worker. AD severity was scored using Scoring Atopic Dermatitis (SCORAD), while QoL was assessed using the Children's Dermatology Life Quality Index Questionnaire (CDLQI) and Family Dermatology Life Quality Index Questionnaire (FDLQI). Biopsychosocial assessments and interventions were also performed. Eighty-three percent of patients received cognitive behavioral therapy, while 40% received social work intervention. There was an overall improvement in mean SCORAD, CDLQI and FDLQI scores across MDC visits. A correlation between AD severity and QoL was established. A patient satisfaction survey showed improvement in severity, understanding and control of disease. Our study suggests the effectiveness of a multidisciplinary approach in managing pediatric AD patients with psychosocial co-morbidities.