Intervenções educativas na dermatite atópica em crianças: o que há de novo? / Educational interventions for atopic dermatitis in children: what's new?

A educação dos cuidadores dos pacientes com dermatite atópica (DA) pode possibilitar a melhora da qualidade de vida e minimizar a gravidade da doença, já que esta tem um imensurável impacto emocional, social e financeiro nas famílias dos doentes. Entretanto, não há um consenso de qual o escopo ideal e frequência para a entrega das informações educativas sobre a patologia e terapêutica. Esta é uma revisão integrativa de literatura cujo objetivo foi avaliar estudos sobre a eficácia de intervenções educativas para pais e pacientes pediátricos com DA na gravidade da doença e na qualidade de vida. Foi realizada uma busca nas bases de dados do PubMed e MEDLINE, em acesso realizado em 08/08/2022, incluindo publicações de 2000 a 2022, nos idiomas português e inglês, incluindo os termos: "atopic dermatitis", "education program", "therapeutic education". Foram incluídos 15 artigos nesta revisão. As metodologias dos estudos são diversas e as ferramentas utilizadas pelos pesquisadores também são heterogêneas, o que dificulta a comparação dos resultados. Dos temas abordados, o cuidado da pele e/ou rotinas básicas foram temas sempre incluídos. E, apesar da literatura demonstrar melhora na gravidade da doença e na qualidade de vida dos cuidadores e pacientes com DA após as intervenções, isso não foi um consenso entre os autores. A educação terapêutica pode ser útil para aumentar a adesão ao tratamento e prevenção de complicações; porém, estudos prospectivos com casuística maior são primordiais para esclarecer qual o escopo ideal e frequência para a entrega destas informações.

Educating the caregivers of patients with atopic dermatitis may lead to improved quality of life and help minimize disease severity, since the pathology has an immeasurable emotional, social, and financial impact on the patient's families. However, there is no consensus on the ideal scope and frequency for providing educational information about atopic dermatitis and its treatment. The purpose of this integrative literature review was to evaluate studies on the effectiveness of educational interventions for parents and pediatric patients with atopic dermatitis regarding disease severity and quality of life. On August 8, 2022, we searched the PubMed and MEDLINE databases for studies published between 2000 and 2022 in Portuguese or English that included the terms: "atopic dermatitis", "education program", and/or "therapeutic education". A total of 15 articles were included in this review. The studies' methodologies and tools were heterogeneous, impeding comparison of the results. Of the covered topics, skin care and/ or basic routines were always included. Although the literature showed that therapeutic education improved disease severity and quality of life for both caregivers and patients, there was no consensus among the authors. Therapeutic education may help increase treatment adherence and prevent complications. However, prospective studies with larger populations are essential for clarifying the ideal scope and frequency of education programs.

Educational intervention and atopic dermatitis: impact on quality of life and treatment.

BACKGROUND: Educational intervention (EI) could improve understanding of atopic dermatitis (AD) and adherence to treatment, decreasing severity, and improving quality of life (QoL). OBJECTIVE: This study aims to evaluate the influence of an EI on the severity of the disease and on the QoL in children with AD. METHODS: A controlled clinical trial was performed, including children up to 14 years of age with AD. Patients were allocated into control group (CG), which received usual guidelines on AD during the outpatient visit, and a study group (SG) that, in addition to the usual guidelines, participated in the EI. The severity of AD was assessed by Scoring Atopic Dermatitis (SCORAD) and Eczema Area and Severity Index (EASI). QoL was assessed by the Children's Dermatology Life Quality Index and the Dermatitis Family Impact Questionnaire. RESULTS: Twenty-seven participants were included in the CG and 21 in the SG. There was a decrease in the median value for the QoL of children in the SG after the intervention (p = 0.04), as well as in the caregiver's (p = 0.04). In the CG, the median QoL of children and caregivers remained unaltered, for caregivers the median value for the QoL was equal throughout first and second evaluation (p = 0.32). In the SG, EASI values decreased after the intervention (p = 0.04), as well as SCORAD (p = 0.04). The CG did not show any decrease in the values of EASI (p = 0.88) scores nor of SCORAD scores (p = 0.82). CONCLUSION: The EI rendered a decrease in severity of the disease and improvement in the QoL of patients and their caregivers.

Vitamin D supplementation and severity of atopic dermatitis: pre-post assessment.

BACKGROUND/OBJECTIVES: There is evidence that vitamin D (VD) supplementation may help in the management of atopic dermatitis (AD). The aim of this study was to assess the influence of VD supplementation on the severity of AD. METHODS: Pre-post interventional study with prospective data collection in patients younger than 14 years. The severity of AD was determined through SCORAD (SCORing Atopic Dermatitis) and classified as mild (SCORAD < 25), moderate (≥25 and <50), and severe (≥50). Skin prick test was performed in all patients. Serum VD levels were classified as sufficient (≥30 ng/mL), insufficient (29 to 21 ng/mL), and deficient (≤20 ng/mL); and those with inadequate levels received oral supplementation of VD for 3 months, and were reassessed after treatment. RESULTS: A total of 152 patients were included. Patients with sufficient vitamin levels had lower SCORAD values (p = 0.04). Further, 116 patients (76.3%) received VD supplementation and after 3 months, VD levels were significantly higher (35.9 ng/mL) compared to baseline levels (23.7 ng/mL, p < 0.001). At the same time, a reduction in the SCORAD index was observed (19.4 before vs 12.3 after supplementation, p < 0.001). Considering other factors that could influence the decrease in AD severity after VD supplementation, female gender was associated with a worse treatment response (p = 0.02). CONCLUSION: Vitamin D supplementation could be an adjuvant in reducing the severity of atopic dermatitis.