By: Guy Heynen, MD
Dermatitis affects the quality of life because it is a chronic disease that is at times quite distressing. The disease may be visible to others, causing embarrassment to the victim. Timely management and the avoidance of triggering factors by numerous outside agents require constant vigilance. All these factors may indeed impact on quality of life.
The first signs of atopic dermatitis occur in young children, and, unless controlled, typically affect the patient's emotional and social development. The disease is a source of embarrassment, discomfort, inconvenience, and misery. It may limit physical and social activity. It can also affect the child's family -- for instance, because of:
Atopic dermatitis can also disturb family relations because the characteristic itch causes loss sleep for the patient, and also often for the rest of the family, resulting in daytime sleepiness, irritability and behavior changes.
The results of the UK Dermatitis Family Impact Questionnaire is very instructive:
Allergic contact dermatitis may occur in response to a vast number of items: 65,725 causative chemicals were identified by a 1993 US National Research Council report, including pesticides, cosmetics, drugs, food additives, and commercial chemicals. Only some of these allergens will be active in each person. So some people may be able to manage their condition by the simple measure of avoiding the source of their allergy. This could mean, for example, not wearing jewelry containing nickel, or clothing with metal fastenings, rubber straps or waistbands, or buying only hypo-allergenic cosmetics. Most of these items often come at increased cost. In other cases, the patient may have occupational problems - for instance a gardener with allergy to pesticides, or a nurse with allergy to latex gloves -- that forces them to abandon a chosen occupation.
Irritant contact dermatitis is generally caused by substances used in the course of work. So here, too, some people will need to retrain for new occupations or positions, or stop working altogether. Others may endure the problem, in order to keep their job, with great discomfort. They may need to take considerable time off work, or their work may be adversely affected
In conclusion, it is clear that dermatitis reduces the quality of the victim's life. The consequences can often be far-reaching, with personal (physical and psychological), social and occupational consequences.
The family impact of childhood atopic dermatitis
HC. Williams, V. Lawson, MS. Lewis-Jones, et al., Brit J Dermatol, 1998, vol. 138, pp. 107--113
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