title: Disease severity and quality of life in children with atopic dermatitis: PO-SCORAD in clinical practice.
abstract: BACKGROUND
  Atopic dermatitis (AD) can significantly compromise the quality of life (QoL). The aim of our investigation was to evaluate whether QoL correlates with AD severity, evaluated through the physician and the patient perspective, in a sample of Italian children.
  
  
  METHODS
  Forty children with AD were evaluated. Disease severity was assessed by the physician and the patients (or their parents) using the SCORAD and the patient-oriented SCORAD (PO-SCORAD) tools, respectively. Patients or their parents completed specific QoL questionnaires (IDQOL/CDLQI). Spearman's correlation coefficient and non-parametric analysis of covariance were used to analyze the data.
  
  
  RESULTS
  SCORAD e PO-SCORAD were moderately but significantly correlated (ρ Spearman=0.55, P<0.01). QoL scores ranged from 1 to 23, with a median score of 4.0 (higher scores represent more impaired QoL). After adjustment for age and sex, children with SCORAD>40 had significantly higher QoL scores (more impaired QoL) than those with SCORAD≤40 (median QoL of 5 and 4, respectively, P=0.048). Even higher differences emerged when AD severity was self-assessed (median QoL of 6 and 3.5 for children with PO-SCORAD>40 and PO-SCORAD≤40, respectively, P=0.01). AD children with concomitant food allergy had a significantly more impaired QoL than those with AD only (P=0.040). No significant difference in QoL was observed according to sex or age.
  
  
  CONCLUSIONS
  In our sample of AD children, QoL appeared slightly-moderately altered, and increasing disease severity was associated with greater impairment in QoL. SCORAD and PO-SCORAD were fairly correlated and the association of QoL was somewhat stronger with the PO-SCORAD than the SCORAD Index. This supports the usefulness of PO-SCORAD for the self-assessment of AD in children, and suggests the importance to integrate physician and patient perspectives in the management of AD.
authors.affiliation: Unit of Pediatric Dermatology, Dermatologic Clinic, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy - boccardi.daniela@tiscali.it.
authors.forename: Daniela
authors.initials: D
authors.lastname: Boccardi
authors.affiliation: Department of Pediatrics, San Paolo Hospital, University of Milan, Milan, Italy.
authors.forename: Enza
authors.initials: E
authors.lastname: D'Auria
authors.affiliation: Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Turati
authors.affiliation: Department of Pediatrics, San Paolo Hospital, University of Milan, Milan, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: DI Vito
authors.affiliation: Department of Pediatrics, San Paolo Hospital, University of Milan, Milan, Italy.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Sortino
authors.affiliation: Department of Pediatrics, San Paolo Hospital, University of Milan, Milan, Italy.
authors.forename: Enrica
authors.initials: E
authors.lastname: Riva
authors.affiliation: Unit of Pediatric Dermatology, Dermatologic Clinic, Department of Health Sciences, San Paolo Hospital, University of Milan, Milan, Italy.
authors.forename: Amilcare
authors.initials: A
authors.lastname: Cerri
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000503:physiopathology*; D059026:Diagnostic Self Evaluation; D005260:Female; D005512:Food Hypersensitivity / Q000150:complications*; D006801:Humans; D007223:Infant; D007558:Italy; D008297:Male; D010290:Parents; D011788:Quality of Life; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires