title: Quality of life in patients with atopic dermatitis: impact of tacrolimus ointment.
abstract: BACKGROUND
  Atopic dermatitis (AD), a significant problem in Japan, has a major impact on health-related quality of life (QOL). The development of steroid phobia in patients with AD may restrict the therapeutic options available to these patients. Tacrolimus ointment is a safe and effective nonsteroid treatment for AD. It may be an appropriate alternative for patients with AD and steroid phobia. The aim of this study was to determine the impact of AD on QOL and to investigate the effect of tacrolimus ointment on QOL in patients with steroid phobia.
  
  
  METHODS
  Firstly, QOL scores were investigated in patients with AD and steroid phobia using the World Health Organization Quality of Life instrument, WHOQOL-26, and were compared with QOL scores from a previous study in volunteers from Tokyo, Japan. Secondly, patients with steroid phobia received tacrolimus ointment treatment for 12 weeks. Quality of life scores were assessed using WHOQOL-26 at baseline and study end.
  
  
  RESULTS
  The overall mean QOL score of 106 patients with AD was significantly lower than that of 708 volunteers (3.1 +/- 0.5 vs. 3.3 +/- 0.5, P < 0.001). The overall QOL score improved from 2.9 +/- 0.4 at baseline to 3.3 +/- 0.4 following 12 weeks' tacrolimus ointment treatment in 35 patients with AD and steroid phobia (P < 0.001).
  
  
  CONCLUSIONS
  Atopic dermatitis significantly lowers QOL. Tacrolimus ointment is associated with a significant improvement in QOL in patients with steroid phobia, indicating that it is an effective alternative to topical corticosteroids in these patients.
authors.affiliation: Department of Dermatology, Tokyo Women's Medical University, Tokyo, Japan. m-kawash@derm.twmu.ac.jp
authors.forename: Makoto
authors.initials: M
authors.lastname: Kawashima
mesh_terms: D001294:Attitude to Health; D003876:Dermatitis, Atopic / Q000188:drug therapy* / Q000503:physiopathology* / Q000523:psychology; D006304:Health Status; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D009824:Ointments; D011788:Quality of Life; D012449:Safety; D012919:Social Behavior; D011795:Surveys and Questionnaires; D016559:Tacrolimus / Q000008:administration & dosage / Q000627:therapeutic use*; D014041:Tokyo; D014944:World Health Organization
chemical_list: D007166:Immunosuppressive Agents; D009824:Ointments; D016559:Tacrolimus