Importance of out-of-pocket costs for adult patients with atopic dermatitis in France.

BACKGROUND: Currently, few studies investigated the economic burden of atopic dermatitis (AD) in adult patients and specifically the estimation of out-of-pocket costs. Patients with skin disorders primarily use comfort care to ease dryness, itch or pain, and the costs of comfort care are not subject to any reimbursement from mandatory or complementary insurance. OBJECTIVE: The purpose of this study was to measure the medical and non-medical expenses paid by the patient. METHODS: Eczema Cohort Longitudinal Adults was a non-interventional study that aimed to assess the burden of AD in terms of quality of life and financial consequences. A self-assessment questionnaire was distributed to adult patients who were cared in four French hospitals. Patients were asked to list the resources consumed for the treatment of AD during the last 12 months and to estimate the corresponding amount of money they had to pay out of their own pockets. The severity of AD was subjected to a stratification based on the PO-SCORAD score. RESULTS: A total of 1024 patients answered the questionnaire: 31.9% with severe AD, 40.4% with moderate AD and 27.6% with mild AD. The mean annual out-of-pocket cost was €462.1 for severe AD and €247.4 for moderate AD. Emollients were the most commonly used product: 74.4% for an average out-of-pocket cost of €151.4. The out-of-pocket costs increased significantly with the severity: 27% of patients with severe AD declared having bought specially textured clothes, while 19% of patients with moderate AD reported the same. The corresponding mean out-of-pocket costs were €162 and €91, respectively. CONCLUSION: The amount of out-of-pocket costs for patients with AD for essential medical and non-medical expenses is relatively high, compared to the average out-of-pocket cost for French households. Integration of these essential resources into the list of reimbursed products and services appears necessary for a better coverage of AD.

The impact of atopic dermatitis on sexual health.

BACKGROUND: Sexual health is frequently affected by chronic diseases but has been poorly investigated in patients with atopic dermatitis (AD). OBJECTIVE: To evaluate the risk factors for impaired sexual desire and its relationship with the burden and quality of life of patients with AD. METHODS: A multicentre prospective transversal study in patients with AD. Socio-demographic and clinical data were obtained from all patients using a specifically developed questionnaire. In addition, patients were asked to answer validated scales, that is ABS-A, DLQI, SF-12 and EQ-5D. RESULTS: A total of 1024 patients participated in the study. Severity of AD, sites involved and treatment type was found to negatively impact the sexual desire of patients and their partners. In addition, the involvement of the genital and visible areas was associated with a higher burden and more significant alterations in quality of life. CONCLUSIONS: The results of this study are substantial and clearly demonstrate the deep impact of AD on sexual health, its relationship with disease-related burden and alterations to quality of life. Psychosociological as well as neurosensory phenomena could help to understand these data.

[Body hair and advertising in French magazines]. / Représentations de la pilosité dans les publicités des magazines en France.

BACKGROUND: Sociological analysis of advertising reveals the currently operative body codes within a society, and more fundamentally, depicts the (ideal) relationships between men and women, between generations, and so on. STUDY AIM: To demonstrate that sports advertising based largely on trichological stereotypes. METHODS: The idealised portrayal of human relations in advertisements (N=700) taken from French magazines was analysed by means of systematic coding and use of analytical software. This approach allowed characterisation of each advertisement in relation to the entire sample, with identification of significant elements (dominant colour, stature of models, setting, etc.), and determination of frequency of appearance and occurrence as well as testing of dependency relations. RESULTS: There were significant differences in the portrayal of men and women in advertisements. In the 700 advertisements in the series we examined, male subjects very often had short hair (231 cases, 33%) or shaved heads (33 cases, 4.7%) while women were shown with long hair, either free (80 cases) or tied (73 cases). Women with short hair were rarely portrayed (4.3%), as were men with long hair (42 cases, 6%). Above all, with the exception of eyebrows and eyelashes, no other body hair was seen in male and female athletic figures in 238 advertisements, being visible in only 60 cases (8.6%). Facial stubble, and more particularly beards and moustaches, was fairly infrequent, despite the omnipresence of male models. DISCUSSION: The majority of advertising situations involving sporting figures show clear stereotyping. Body hair is a pertinent pointer to understanding of contemporary sports models. A clear overall male/female distinction was present throughout. Men were presented in these adverts as active figures, leaders, etc. while women tended to be passive, spectators, and in some cases, admiring onlookers. A degree of confusion between genders was noticeable as a result of the shaving and depilation trends currently in vogue in the sporting world on aesthetic and practical grounds. The bodies portrayed were smooth and hairless, and somewhat removed from reality (i.e. the animal side of human beings). CONCLUSION: The advertising domain tends to portray classical morphological and behavioural models rather than less conformist representations. Marketing communications depict ideal skins, with none of the commonly seen roughness, and more particularly none of the skin conditions (dermatoses, grazing, scars, etc.) so commonly seen in sports figures. The overall image conveyed is a far cry indeed from the actual epidemiological reality encountered by dermatologists!