Johannesburg- Sanofi in collaboration with The Allergy Foundation of South Africa hosted an educational webinar for patients with Atopic Dermatitis (AD) often referred to as atopic eczema or just eczema. This webinar which took place on the 28th of July under the theme: The mental health impact of living with atopic eczema addressed the emotional trauma and mental stress that comes with this condition.
AD is a chronic, relapsing, immune-mediated inflammatory skin disease that causes intense itching and discomfort which can result in unsightly lesions that together may cause sleeplessness, social embarrassment, depression, and anxiety impairing the quality of life of both sufferers and their families.1
“AD is often seen as ‘just a skin condition, but a patient living with eczema is impacted in many aspects of their daily life. The disease affects their physical, social, and mental health. Eczema is a visible condition, often affecting skin folds, but could readily affect the face, neck, and hands. This not only affects self-esteem and confidence, leaving patients feeling embarrassed to show their skin or reluctant to mix with others, which can lead to them feeling very alone and isolated”, says Dr Dwayne Koot, Medical advisor at Sanofi. “Often, a person living with AD feels shame and rejection. These feelings may lead to Depression and Anxiety. This worsens the eczema because stress feelings trigger the immune system and lead to flare ups. We treat the depression and anxiety with appropriate medication, thus lowering the person’s stress and improving the outcome of the eczema” added Dr Lerato Dikobe-Kalane, Psychiatrist.
“AD is driven in part by type 2 inflammation, a dysregulated immune response, which contributes to intense, persistent itching often worst at night leading to terrible sleep quality for patients and caregivers. Type 2 inflammation plays a role in multiple diseases that are seemingly unrelated, but often coexist. Uncontrolled, moderate-to-severe AD can have a substantial physical, emotional, social, and psychological impact, continues Dr Koot.
There has been an increase in research publications raising awareness on the connection between dermatological diseases such as AD with concerning findings showing that adults with AD have a two-and-a-half to three-fold higher risk for anxiety or depression that increases with disease severity.2-3
“Although most studies on the correlation between emotional wellness and AD in adults were conducted in the United Kingdom or United States, the Allergy Foundation has seen similar disturbing patterns emerge in South Africa hence we saw the need to host these webinars and open it up to the public for more engagement,” says Candice Royal, Paediatric Allergist, for Allergy Foundation South Africa.
Findings from a study published in the Journal of American Medical Association (JAMA) that was taken from 15 international studies found that people with AD were approximately 44% more likely to have suicidal thoughts than those without the disease and that AD was also seen to put patients at 36% higher risk for attempting suicide. 4
South Africa has seen an increase in suicide cases and has been ranked the third highest rate out of all African countries with reports showing that 13,774 suicides were reported in South Africa in 2019 according to the World Health Organization (WHO). 5
The suffering experienced by severe AD patients and the dramatic impact on quality of life, perhaps leading to depression and even thoughts of suicide is of great concern to us. In collaboration, we are trying to find tangible solutions to tackle this issue and improve patient outcomes and health-related quality of life. Creating safe spaces for this kind of dialogue provides one of the first steps towards combating stigmatization and promoting patient therapeutic education initiatives aimed towards better self-management of the disease and seeking appropriate medical intervention”, says Dr Koot from Sanofi.
“Atopic eczema has a profound underacknowledged effect on the quality of life of patients as well as caregivers. Acknowledging the chronicity of the condition is the first step. Then aligning yourself with a healthcare provider with a particular interest in atopic eczema is the next. Care should be focused on treating the skin but also managing the psychological impact on the patient and the whole family. The Atopic Eczema Support Group on Facebook and Instagram will place you in touch with people experiencing the same challenges related to atopic eczema. Patients living with eczema and their families should consider joining the support groups” said Dr Suretha Kannenberg, Clinical Dermatologist.
To find out more about how you can be part of this engagement click on the below link:
https://fb.watch/eFVH3JQDBw/
References
- Schonmann Y, Mansfield K, Hayes JF, , et al. Atopic Eczema in Adulthood and Risk of Depression and Anxiety: A Population-Based Cohort . J Allergy Clin Pract 2020 Jan 8(1): 248–257.e16 doi: 10.1016/j.jaip.2019.08.030
2 Cheng BT, Silverberg JI. Depression and psychological distress in US adults with atopic dermatitis. Ann Allergy Asthma Immunol. 2019;123(2):179-185
- Yu SH, Silverberg JI. Association between Atopic Dermatitis and Depression in US Adults. J Invest Dermatol. 2015;135(12):3183-3186.
- Sandhu JK, Wu KK, Bui TL, Armstrong AW. Association Between Atopic Dermatitis and Suicidality: A Systematic Review and Meta-analysis. JAMA Dermatol. 2019;155(2):178-187.
- WHO (2020). Global Health Estimates 2019: deaths by cause, age, sex, by country and by region, 2000–2019. Geneva: World Health Organization [Online].Available at: https://www.who.int/publications/i/item/9789240026643.
[Accessed on : 20/07/2022]
