Patient-reported outcomes for atopic dermatitis in early childhood

Summary: Abstract Body: Atopic dermatitis (AD) is the most common chronic skin disease affecting young children and is associated with significant disruptions in sleep and mental health. As AD symptoms are often more burdensome than what traditional clinician-reported disease assessments may capture, patient-reported outcome measures (PROMs) are essential to understanding the full experience of AD in young children and their caregivers. However, few studies have evaluated PROMs for sleep and mental health in early childhood AD. This cross-sectional study thus evaluated the Patient-Reported Outcomes Measurement Information System (PROMIS) Early Childhood (EC) parent-report measures for Sleep Problems, Anxiety, and Depressive Symptoms among 104 children <6 years old seen at Johns Hopkins Hospital between July 2022 and September 2024. PROMIS measure T-scores were standardized to a population mean of 50 (SD 10) and AD severity was measured using the Patient-Oriented Eczema Measure (POEM). Sleep Problems were significantly associated with AD severity, with median T-scores increasing from 51.3 (IQR 43.0–59.7) in children with mild AD (POEM ≤7) to 63.5 (IQR: 57.2–67.3) in those with severe AD (POEM ≥17) (p<0.001). Compared to the general population, sleep was significantly worse among our AD cohort (p<0.001), highlighting the substantial negative impact of early childhood AD on sleep. Though not significantly different by AD severity, anxiety symptoms increased significantly with age, with median T-scores rising from 45.6 (IQR 43.0–56.5) in 1-year-olds to 57.0 (IQR 50.0–61.6) in 5-year-olds (p=0.03). Depressive Symptoms scores were slightly higher in young children with severe AD (median 54.5, IQR 40.5–62.4) but not statistically significantly different from milder AD. Our findings support the use of PROMIS EC measures to assess the burden of AD in young children. Greater attention to AD-related sleep problems and further characterization of when mental health challenges develop in this population would enhance our understanding of the psychosocial impact of early childhood AD. Rebecca Urbonas¹, Sumrah Jilani¹, Hsing-Jou Su¹, Karin Kartawira¹, A Grossberg¹, Joy Wan¹ 1. Johns Hopkins University, Baltimore, MD, United States. Clinical Research: Epidemiology and Observational Research