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Dry Skin in Childhood and the Misery of Eczema and Its Treatments

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Abstract

Dry skin represents the earliest clinical sign of atopic eczema and is associated with underlying subclinical inflammatory changes. Complex gene-environment interactions in eczema lead to epidermal barrier dysfunction and immunopathological changes associated with allergic sensitisation. The epidermal protein filaggrin plays a key role in epidermal cell terminal differentiation and skin barrier integrity. Inheritance of loss-of-function filaggrin genes (FLG) causes ichthyosis vulgaris and carries an extremely high risk of developing severe, early-onset eczema often persisting into adult life. The impact on quality of life (QoL) caused by eczema is similar to that from other more serious systemic diseases, and QoL studies indicate that it greatly affects the psychosocial functioning of children and their family unit. The physical effects of itching, pain, sleep loss and exhaustion and the psychological stress from the practicalities of caring for eczema cause misery and interfere with a normal lifestyle. Lack of adherence to therapy has complex causes but is the main reason for poor disease control. Education and a good patient-physician relationship is the most successful way of encouraging good treatment adherence.

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References

  1. Tagami H, Kobayashi H, O’goshi K, Kikuchi K (2006) Atopic xerosis: employment of noninvasive biophysical instrumentation for the functional analyses of the mildly abnormal stratum corneum and for the efficacy assessment of skin care products. J Cosmet Dermatol 5(2):140–149

    Article  PubMed  Google Scholar 

  2. Cork MJ, Danby SG, Vasilopoulos Y, Hadgraft J, Lane ME, Moustafa M, Guy RH, Macgowan AL, Tazi-Ahnini R, Ward SJ (2009) Epidermal barrier dysfunction in atopic dermatitis. J Invest Dermatol 129(8):1892–1908, Epub 2009 Jun 4

    Article  PubMed  CAS  Google Scholar 

  3. Flohr C, England K, Radulovic S, McLean WH, Campbel LE, Barker J, Perkin M, Lack G (2010) Filaggrin loss-of-function mutations are associated with early-onset eczema, eczema severity and ­transepidermal water loss at 3 months of age. Br J Dermatol 163(6):1333–1336

    Article  PubMed  CAS  Google Scholar 

  4. O’Regan GM, Sandilands A, McLean WH, Irvine AD (2008) Filaggrin in atopic dermatitis. J Allergy Clin Immunol 122(4):689–693, Epub 2008 Sep 5

    Article  PubMed  Google Scholar 

  5. Smith FJ, Irvine AD, Terron-Kwiatkowski A, Sandilands A, Campbell LE, Zhao Y, Liao H, Evans AT, Goudie DR, Lewis-Jones S, Arseculeratne G, Munro CS, Sergeant A, O’Regan G, Bale SJ, Compton JG, DiGiovanna JJ, Presland RB, Fleckman P, McLean WH (2006) Loss-of-function mutations in the gene encoding filaggrin cause ichthyosis vulgaris. Nat Genet 38(3):337–342

    Article  PubMed  CAS  Google Scholar 

  6. Palmer CN, Irvine AD, Terron-Kwiatkowski A, Zhao Y, Liao H, Lee SP, Goudie DR, Sandilands A, Campbell LE, Smith FJ, O’regan GM, Watson RM, Cecil JE, Bale SJ, Compton JG, Digiovanna JJ, Fleckman P, Lewis-Jones S, Arseculeratne G, Sergeant A, Munro CS, El Houate B, McElreavey K, Halkjaer LB, Bisgaard H, Mukhopadhyay S, McLean WH (2006) Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis. Nat Genet 38(4):441–446, Epub 2006 Mar 19

    Article  PubMed  CAS  Google Scholar 

  7. Barker JN, Palmer CN, Zhao Y, Liao H, Hull PR, Lee SP, Allen MH, Meggitt SJ, Reynolds NJ, Trembath RC, McLean WH (2007) Null mutations in the filaggrin gene (FLG) determine major susceptibility to early-onset atopic dermatitis that persists into adulthood. J Invest Dermatol 127(3):564–567, Epub 2006 Sep 21

    Article  PubMed  CAS  Google Scholar 

  8. O’Regan Gráinne M, Campbell Linda E, Cordell Heather J, Irvine Alan D, Irwin McLean WH, Brown Sara J (2010) Chromosome 11q13.5 variant associated with childhood eczema: an effect supplementary to filaggrin mutations. J Allergy Clin Immunol 125(1–4):170–174

    Article  PubMed  Google Scholar 

  9. Brown SJ, McLean WHI (2009) Eczema genetics: current state of knowledge and future goals. J Invest Dermatol 129:543–552

    Article  PubMed  CAS  Google Scholar 

  10. Langan SM, Williams HC (2006) What causes worsening of eczema? A systematic review. Br J Dermatol 155(3):504–514

    Article  PubMed  CAS  Google Scholar 

  11. Langan SM, Silcocks P, Williams HC (2009) What causes flares of eczema in children? Br J Dermatol 161(3):640–646, Epub 2009 Jun 5

    Article  PubMed  CAS  Google Scholar 

  12. Shams K, Grindlay DJ, Williams HC (2011) What’s new in atopic eczema? An analysis of systematic reviews published in 2009–2010. Clin Exp Dermatol 36(6):573–577. doi:10.1111/j.1365–2230.2011.04078.x;quiz 577–8. Epub 2011 Jul 1

    Article  PubMed  CAS  Google Scholar 

  13. Schmitt J, Apfelbacher CJ, Flohr C (2011) Eczema. Clin Evid (Online) pii:1716

    Google Scholar 

  14. Blume-Peytavi U, Cork MJ, Faergemann J, Szczapa J, Vanaclocha F, Gelmetti C (2009) Bathing and cleansing in newborns from day 1 to first year of life: recommendations from a European round table meeting. J Eur Acad Dermatol Venereol 23(7):751–759

    Article  PubMed  CAS  Google Scholar 

  15. Thomas KS, Koller K, Dean T, O’Leary CJ, Sach TH, Frost A, Pallett I, Crook AM, Meredith S, Nunn AJ, Burrows N, Pollock I, Graham-Brown R, O’Toole E, Potter D, Williams HC (2011) A multicentre ­randomised controlled trial and economic evaluation of ion-exchange water softeners for the treatment of eczema in children: the Softened Water Eczema Trial (SWET). Health Technol Assess 15(8):v–vi, 1–156

    CAS  Google Scholar 

  16. Lucky AW, Leach AD, Laskarzewski P, Wenck H (1997) Use of an emollient as a steroid sparing agent in the treatment of mild to moderate atopic dermatitis in children. Pediatr Dermatol 14:321–324

    Article  PubMed  CAS  Google Scholar 

  17. NHS (2007) NICE guidelines on management of atopic eczema in children from birth up to the age of 12 years, CG057, http://guidance.org.uk/CG57, Dec 2007

  18. Lewis-Jones S, Mugglestone MA, Guideline Development Group (2007) Management of atopic eczema in children aged up to 12 years: summary of NICE guidance. BMJ 335(7632):1263–1264

    Article  PubMed  Google Scholar 

  19. Darsow U, Wollenberg A, Simon D, Taïeb A, Werfel T, Oranje A, Gelmetti C, Svensson A, Deleuran M, Calza AM, Giusti F, Lübbe J, Seidenari S, Ring J, European Task Force on Atopic Dermatitis/EADV Eczema Task Force (2010) ETFAD/EADV eczema task force 2009 position paper on diagnosis and treatment of atopic dermatitis. J Eur Acad Dermatol Venereol 24(3):317–328, Epub 2009 Aug 31

    Article  PubMed  CAS  Google Scholar 

  20. SIGN: Management of atopic eczema in primary care SIGN guideline 125. http://sign.ac.uk/guidelines/fulltext/125/index.html 2011 accessed 31.1.12

  21. Hanifin JM, Cooper KD, Ho VC, Kang S, Krafchik BR, Margolis DJ et al (2004) Guidelines of care for atopic dermatitis, developed in accordance with the American Academy of Dermatology (AAD)/American Academy of Dermatology Association “Administrative Regulations for Evidence-Based Clinical Practice Guidelines”. J Am Acad Dermatol 50:391–404

    Article  PubMed  Google Scholar 

  22. Frankel A, Sohn A, Patel RV, Lebwohl M (2011) Bilateral comparison study of pimecrolimus cream 1% and a ceramide-hyaluronic acid emollient foam in the treatment of patients with atopic dermatitis. J Drugs Dermatol 10(6):666–672

    PubMed  CAS  Google Scholar 

  23. Grimalt R, Mengeaud V, Cambazard F, Study Investigators’ Group (2007) The steroid-sparing effect of an emollient therapy in infants with atopic dermatitis: a randomized controlled study. Dermatology 214(1):61–67

    Article  PubMed  CAS  Google Scholar 

  24. Kantor I, Milbauer J, Psoner M, Weinstock IM, Simon A, Thormahlen S (1993) Efficacy and safety of emollients as adjunctive agents in topical corticosteroid therapy for atopic dermatitis. Today Ther Trends 11:157–166

    Google Scholar 

  25. Hon KL, Wang SS, Lau Z, Lee HC, Lee KK, Leung TF, Luk NM (2011) Pseudoceramide for childhood eczema: does it work? Hong Kong Med J 17(2):132–136

    PubMed  CAS  Google Scholar 

  26. Global Resource of EczemA Trials (GREAT database) 2000–2011. www.greatdatabase.org.uk/

  27. Beattie PE, Lewis-Jones MS (2004) A pilot study on the use of wet wraps in infants with moderate atopic eczema. Clin Exp Dermatol 29:348–353

    Article  PubMed  CAS  Google Scholar 

  28. Fonacier LS, Aquino MR (2010) The role of contact allergy in atopic dermatitis. Immunol Allergy Clin North Am 30(3):337–350

    Article  PubMed  Google Scholar 

  29. Boussault P, Léauté-Labrèze C, Saubusse E, Maurice-Tison S, Perromat M, Roul S et al (2007) Oat sensitization in children with atopic dermatitis: prevalence, risks and associated factors. Allergy 62:1251–1256, Allergy (2008) 63:781–782

    Article  PubMed  CAS  Google Scholar 

  30. Kränke B, Komericki P, Aberer W (1997) Olive oil-contact sensitizer or irritant? Contact Dermatitis 36(1):5–10

    Article  PubMed  Google Scholar 

  31. Tsang M, Guy RH (2010) Effect of Aqueous Cream BP on human stratum corneum in vivo. Br J Dermatol 163(5):954–958

    Article  PubMed  CAS  Google Scholar 

  32. Mohammed D, Matts PJ, Hadgraft J, Lane ME (2011) Influence of Aqueous Cream BP on corneocyte size, maturity, skin protease activity, protein content and transepidermal water loss. Br J Dermatol 164(6):1304–1310

    Article  PubMed  CAS  Google Scholar 

  33. Wolf G, Höger PH (2009) Hypoallergenic and non-toxic emollient therapies for children. J Dtsch Dermatol Ges 7(1):50–60

    PubMed  Google Scholar 

  34. Lewis-Jones MS, Finlay AY (1995) The children’s dermatology life quality index (CDLQI): initial validation and practical use. Br J Dermatol 132:942–949

    Article  PubMed  CAS  Google Scholar 

  35. Lawson V, Lewis-Jones MS, Finlay AY, Reid P, Owens RG (1998) The family impact of childhood atopic dermatitis: the dermatitis family impact questionnaire. Br J Dermatol 138:107–113

    Article  PubMed  CAS  Google Scholar 

  36. Lewis-Jones MS, Finlay AY, Dykes P (2001) The infants’ dermatitis quality of life index (IDQOL). Br J Dermatol 144:104–110

    Article  PubMed  CAS  Google Scholar 

  37. Lewis-Jones S (2006) Quality of life and childhood atopic dermatitis: the misery of living with childhood eczema. Int J Clin Pract 60(8):984–992

    Article  PubMed  CAS  Google Scholar 

  38. Lewis-Jones MS, Charman CR (2011) Atopic Dermatitis: scoring severity and quality of life assessment. In: Irvine A, Hoeger P, Yan A (eds) Harper’s textbook of pediatric dermatology (third Edition) Vol 1 chapter 29 pp 29.9-29.16 Publisher Wiley-Blackwell

    Google Scholar 

  39. Reid P, Lewis-Jones MS (1995) Sleep disturbance in preschoolers with atopic eczema. Clin Exp Dermatol 20:38–41

    Article  PubMed  CAS  Google Scholar 

  40. Daud LR, Garralda ME, David TJ (1993) Psychosocial adjustment in preschool children with atopic eczema. Arch Dis Child 69(6):670–676

    Article  PubMed  CAS  Google Scholar 

  41. Long CC, Funnell CM, Collard R, Finlay AY (1993) What do members of the National Eczema Society really want? Clin Exp Dermatol 18(6):516–522

    Article  PubMed  CAS  Google Scholar 

  42. Stores G, Burrows AB, Crawfors C (1998) Physiological sleep disturbance in children with atopic eczema: a case controlled study. Pediatr Dermatol 15:264–268

    Article  PubMed  CAS  Google Scholar 

  43. Beattie PE, Lewis-Jones MS (2006) A Comparative study of impairment of Quality of Life (QoL) in children with skin disease and children with other chronic childhood diseases. Br J Dermatol 155:145–151

    Article  PubMed  CAS  Google Scholar 

  44. Chamlin SL, Mattson CL, Frieden IJ, Williams ML, Mancini AJ, Cella D, Chren MM (2005) The price of pruritus: sleep disturbance and cosleeping in atopic dermatitis. Arch Pediatr Adolesc Med 159(8):745–750

    Article  PubMed  Google Scholar 

  45. Paller AS, McAlister RO, Doyle JJ, Jackson A (2002) Perceptions of physicians and pediatric patients about atopic dermatitis, its impact, and its treatment. Clin Pediatr (Phila) 41(5):323–332

    Article  Google Scholar 

  46. Aledan M, Gonzales M, Finlay AY (2000) Utility measures for children with skin disease. J Eur Acad Dermato Venereol 14(S1):281 (Abstract)

    Google Scholar 

  47. Carvalho NF, Kenney RD, Carrington PH, Hall DE (2001) Severe nutritional deficiencies in toddlers resulting from health food milk alternatives. Pediatrics 107(4):E46

    Article  PubMed  CAS  Google Scholar 

  48. Bath-Hextall FJ, Delamere FM, Williams HC. Dietary exclusions for established atopic eczema. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD005203. DOI: 10.1002/14651858.CD005203.pub2. Published Online:8 OCT 2008

    Google Scholar 

  49. Warschburger P, Buchholz HT, Petermann F (2004) Psychological adjustment in parents of young children with atopic dermatitis: which factors predict parental quality of life? Br J Dermatol 150(2):304–311

    Article  PubMed  CAS  Google Scholar 

  50. Titman PS, Barker C, Smith CH (2001) The psychological impact of chronic eczema on children and their families. Br J Dermatol 145(S59):128–129 (Abstract)

    Google Scholar 

  51. Faught J, Bierl C, Barton B, Kemp A (2007) Stress in mothers of young children with eczema. Arch Dis Child 92(8):683–686, Epub 2007 Apr 5

    Article  PubMed  Google Scholar 

  52. Absolon C, Cottrell D, Eldridge S, Glover M (1997) Psychological disturbance in atopic eczema: the extent of the problem in school aged children. Br J Dermatol 137:241–245

    Article  PubMed  CAS  Google Scholar 

  53. Sarkar R, Raj L, Kaur H, Basu S, Kanwar AJ, Jain RK (2004) Psychological disturbances in Indian children with atopic eczema. J Dermatol 31(6):448–454

    PubMed  Google Scholar 

  54. Schmitt J, Romanos M, Pfennig A, Leopold K, Meurer M (2009) Psychiatric comorbidity in adult eczema. Br J Dermatol 161(4):878–883, Epub 2009 Jul 14

    Article  PubMed  CAS  Google Scholar 

  55. Chamlin SL, Cella D, Frieden IJ, Williams ML, Mancini AJ, Lai JS, Chren MM (2005) Development of the Childhood Atopic Dermatitis Impact Scale: initial validation of a quality-of-life measure for young children with atopic dermatitis and their families. J Invest Dermatol 125(6):1106–1111

    Article  PubMed  CAS  Google Scholar 

  56. Su J, Kemp A, Varigos G, Nolan T (1997) Atopic eczema: its impact on the family and financial cost. Arch Dis Child 76(2):159–162

    Article  PubMed  CAS  Google Scholar 

  57. Lapidus CS, Kerr PE (2001) Social impact of atopic dermatitis. Med Health R I 84(9):294–295

    PubMed  CAS  Google Scholar 

  58. Balkrishnan R, Housman T, Carroll C, Feldman S, Fleischer A (2003) Disease severity and associated family impact in childhood atopic dermatitis. Arch Dis Child 88(5):423–427

    Article  PubMed  CAS  Google Scholar 

  59. Carroll CL, Balkrishnan R, Feldman SR, Fleischer AB Jr, Manuel JC (2005) The burden of atopic dermatitis: impact on the patient, family, and society. Pediatr Dermatol 22(3):192–199

    Article  PubMed  Google Scholar 

  60. Emerson R, Williams HC, Allen BR (2001) What is the cost of atopic dermatitis in preschool children? Br J Dermatol 144:514–522

    Article  PubMed  CAS  Google Scholar 

  61. Herd RM, Tidman MJ, Prescott RJ, Hunter JA (1996) The cost of atopic eczema. Br J Dermatol 135(1):20–23

    Article  PubMed  CAS  Google Scholar 

  62. Schuttelaar ML, Vermeulen KM, Coenraads PJ (2011) Costs and cost-effectiveness analysis of treatment in children with eczema by nurse practitioner vs. dermatologist: results of a randomized, controlled trial and a review of international costs. Br J Dermatol 165(3):600–611

    Article  PubMed  CAS  Google Scholar 

  63. Zuberbier T, Orlow SJ, Paller AS, Taïeb A, Allen R, Hernanz-Hermosa JM, Ocampo-Candiani J, Cox M, Langeraar J, Simon JC (2006) Patient perspectives on the management of atopic dermatitis. J Allergy Clin Immunol 118(1):226–232

    Article  PubMed  Google Scholar 

  64. Collier J, MacKinlay D, Phillips D (2000) Norm values for the Generic Children’s Quality of Life Measure (GCQ) from a large school-based sample. Qual Life Res 9(6):617–623

    Article  PubMed  CAS  Google Scholar 

  65. Eiser C, Morse R (2001) Can parents rate their child’s health-related quality of life? Results of a systematic review. Qual Life Res 10(4):347–357

    Article  PubMed  CAS  Google Scholar 

  66. Ben-Gashir MA, Seed PT, Hay RJ (2004) Quality of life and disease severity are correlated in children with atopic dermatitis. Br J Dermatol 150(2):284–290

    Article  PubMed  CAS  Google Scholar 

  67. Kupfer J, Gieler U, Diepgen TL, Fartasch M, Lob-Corzilius T, Ring J, Scheewe S, Scheidt R, Schnopp C, Szczepanski R, Staab D, Werfel T, Wittenmeier M, Wahn U, Schmid-Ott G (2010) Structured education program improves the coping with atopic dermatitis in children and their parents-a multicenter, randomized controlled trial. J Psychosom Res 68(4):353–358

    Article  PubMed  Google Scholar 

  68. Emerson RM, Williams HC, Allen BR (1997) How much disability does childhood atopic eczema cause compared to other childhood problems. Br J Dermatol 137:19 (Abstract)

    Google Scholar 

  69. McKenna SP, Whalley D, Dewar AL, Erdman RA, Kohlmann T, Niero M, Baró E, Cook SA, Crickx B, Frech F, van Assche D (2005) International development of the Parents’ Index of Quality of Life in Atopic Dermatitis (PIQoL-AD). Qual Life Res 14(1):231–241

    Article  PubMed  Google Scholar 

  70. Holme SA, Man I, Sharpe JL, Dykes PJ, Lewis-Jones MS, Finlay AY (2003) The Children’s Dermatology Life Quality Index: validation of the cartoon version. Br J Dermatol 148(2):285–290

    Article  PubMed  CAS  Google Scholar 

  71. Beattie PE, Lewis-Jones MS (2006) An audit of the impact of a consultation with a paediatric dermatology team on quality of life in infants with atopic eczema and their families: further validation of the Infants’ Dermatitis Quality of Life Index and Dermatitis Family Impact score. Br J Dermatol 155(6):1249–1255

    Article  PubMed  CAS  Google Scholar 

  72. Ben-Gashir MA, Seed PT, Hay RJ (2002) Are quality of family life and disease severity related in childhood atopic dermatitis? J Eur Acad Dermatol Venereol 16(5):455–462

    Article  PubMed  CAS  Google Scholar 

  73. Aziah MS, Rosnah T, Mardziah A, Norzila MZ (2002) Childhood atopic dermatitis: a measurement of quality of life and family impact. Med J Malaysia 57(3):329–339

    PubMed  Google Scholar 

  74. Chamlin SL, Lai JS, Cella D, Frieden IJ, Williams ML, Mancini AJ, Chren MM (2007) Childhood Atopic Dermatitis Impact Scale: reliability, discriminative and concurrent validity, and responsiveness. Arch Dermatol 143(6):768–772

    Article  PubMed  Google Scholar 

  75. Lundberg L, Johannesson M, Silverdahl M, Hermansson C, Lindberg M (1999) Quality of life, health-state utilities and willingness to pay in patients with psoriasis and atopic eczema. Br J Dermatol 141(6):1067–1075

    Article  PubMed  CAS  Google Scholar 

  76. Krejci-Manwaring J, Tusa MG, Carroll C, Camacho F, Kaur M, Carr D, Fleischer AB Jr, Balkrishnan R, Feldman SR (2007) Stealth monitoring of adherence to topical medication: adherence is very poor in children with atopic dermatitis. J Am Acad Dermatol 56(2):211–216, Epub 2006 Nov 13

    Article  PubMed  Google Scholar 

  77. Bradley C (1999) Compliance with drug therapy. Prescribers J 39(1):44–50

    Google Scholar 

  78. Serup J, Lindblad AK, Maroti M, Kjellgren KI, Niklasson E, Ring L, Ahlner J (2006) To follow or not to follow dermatological treatment – a review of the literature. Acta Derm Venereol 86(3):193–197

    Article  PubMed  Google Scholar 

  79. Zaghloul S, Goodfield M (2004) Objective assessment of compliance with psoriasis treatment. Arch Dermatol 140:408–414

    Article  PubMed  Google Scholar 

  80. Zaghloul S, Cunliffe W, Goodfield M (2005) Objective assessment of compliance with treatments in acne. Br J Dermatol 152(5):1015–1021

    Article  PubMed  CAS  Google Scholar 

  81. Carroll CL, Feldman SR, Camacho FT, Manuel JC, Balkrishnan R (2004) Adherence to topical therapy decreases during the course of an 8-week psoriasis clinical trial: commonly used methods of measuring adherence to topical therapy overestimate actual use. J Am Acad Dermatol 51(2):212–216

    Article  PubMed  Google Scholar 

  82. Feldman SR, Camacho FT, Krejci-Manwaring J, Carroll CL, Balkrishnan R (2007) Adherence to topical therapy increases around the time of office visits. J Am Acad Dermatol 57(1):81–83, Epub 2007 May 10

    Article  PubMed  Google Scholar 

  83. Beattie PE, Lewis-Jones MS (2003) Parental Knowledge of topical therapies used in the treatment of atopic dermatitis. Clin Exp Dermatol 28:549–553

    Article  PubMed  CAS  Google Scholar 

  84. Ickovics JR (2002) Consequences and determinants of adherence to antiretroviral medication. Antivir Ther 7(3):185–193

    PubMed  Google Scholar 

  85. Charman C, Williams H (2003) The use of corticosteroids and corticosteroid phobia in atopic dermatitis. Clin Dermatol 21(3):193–200

    Article  PubMed  Google Scholar 

  86. Long C, Finlay AY (1993) Perceived under prescription of topical therapy. Br J Gen Pract 43:305

    PubMed  CAS  Google Scholar 

  87. Santer M, Lewis-Jones S, Fahey T (2006) Appropriateness of prescribing for childhood eczema: evidence form a community-based study. Clin Exp Dermatol 31:671–673

    Article  PubMed  CAS  Google Scholar 

  88. Vaughan V (1966) Emotional undertones in eczema in children. J Asthma Res 3:193

    Article  PubMed  Google Scholar 

  89. Halm EA et al (2006) No symptoms, no asthma: the acute episodic disease belief is associated with poor self-management among inner-city adults with persistent asthma. Chest 129:573–580

    Article  PubMed  Google Scholar 

  90. Ohya Y, Williams H, Steptoe A, Saito H, Iikura Y, Anderson R, Akasawa A (2001) Psychosocial factors and adherence to treatment advice in childhood atopic dermatitis. J Invest Dermatol 117(4):852–857

    Article  PubMed  CAS  Google Scholar 

  91. Renzi C et al (2001) Factors associated with patient satisfaction with care among dermatological outpatients. Br J Dermatol 145(4):617–623

    Article  PubMed  CAS  Google Scholar 

  92. Kjellgren KI, Ring L, Lindblad AK, Maroti M, Serup J (2004) To follow dermatological treatment regimens-patients’ and providers’ views. Acta Derm Venereol 84(6):445–450

    Article  PubMed  Google Scholar 

  93. Broberg A, Kalimo K, Lindblad B, Swanbeck G (1990) Parental education in the treatment of childhood atopic eczema. Acta Derm Venereol 70(6):495–499

    PubMed  CAS  Google Scholar 

  94. Cork MJ, Britton J, Butler L, Young S, Murphy R, Keohane SG (2003) Comparison of parent knowledge, therapy utilization and severity of atopic eczema before and after explanation and demonstration of topical therapies by a specialist dermatology nurse. Br J Dermatol 149(3):582–589

    Article  PubMed  CAS  Google Scholar 

  95. Gradwell C, Thomas KS, English JS, Williams HC (2002) A randomized controlled trial of nurse follow-up clinics: do they help patients and do they free up consultants’ time? Br J Dermatol 147(3):513–517

    Article  PubMed  CAS  Google Scholar 

  96. Moore EJ, Williams A, Manias E, Varigos G, Donath S (2009) Eczema workshops reduce severity of childhood atopic eczema. Australas J Dermatol 50(2):100–106

    Article  PubMed  Google Scholar 

  97. Staab D et al (2006) Age related, structured educational programmes for the management of atopic dermatitis in children and adolescents: multicentre, randomised controlled trial. BMJ 332(7547):933–938

    Article  PubMed  Google Scholar 

  98. Stalder JF, Bernier C, Ball A, De Raeve L, Gieler U, Deleuran M, Marcoux D, Eichenfield L, Lio P, Lewis-Jones S, Gelmetti C, Takaoka R, Chiaverini C, Misery L, Barbarot S, for the Oriented Patient-Education Network in Dermatology (OPENED) (2011) Therapeutic patient education on atopic dermatitis: worldwide experiences. Br J Dermatol http://opened-dermatology.com/ (accessed 31.1.12)

  99. Ersser SJ, Latter S, Sibley A, Satherley PA, Welbourne S. Psychological and educational interventions for atopic eczema in children. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.:CD004054. DOI: 10.1002/14651858.CD004054.pub2. Published Online: 21 JAN 2009

    Google Scholar 

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Lewis-Jones, S. (2012). Dry Skin in Childhood and the Misery of Eczema and Its Treatments. In: Lodén, M., Maibach, H. (eds) Treatment of Dry Skin Syndrome. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-27606-4_4

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