Atopic Dermatitis and Patient Perspectives: Insights of Bullying at School and Career Discrimination at Work

Abstract

Luca Stingeni,1 Anna Belloni Fortina,2 Ilaria Baiardini,3,4 Katharina Hansel,1 Devis Moretti,5 Filippo Cipriani5 1Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy; 2Unit of Dermatology, Department of Medicine - DIMED, University of Padua, Padua, Italy; 3Respiratory Unit for Continuity of Care, IRCCS, Ospedale Policlinico San Martino, Genova, Italy; 4Personalized Medicine Asthma, & Allergy Clinic, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; 5Sanofi Genzyme, Sanofi S.r.l., Milan, ItalyCorrespondence: Anna Belloni FortinaUnit of Dermatology, Department of Medicine – DIMED, University of Padua, Via Gallucci, 4, Padova, 35128, ItalyEmail [email protected]: Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by recurrent eczematous lesions and intense pruritus. AD patients are known to face a considerable disease burden, including physical and emotional limitations. There is still limited knowledge about daily implications in education and occupation. We describe disease social stigmatization by measuring bullying and self-isolation in students and professional discrimination in workers. Overall loss of productivity, either at school and at the workplace, was quantified as the sum of absenteeism (number of days AD sick leave) and presenteeism (number of days with decreased focus and functionality).Methods: An on-line web survey was sent to 3235 random recipients and 401 met the inclusion criteria (self-reporting AD and ≥ 12 yo). The survey domains included daily limitations, QoL, feelings and relationships, together with specific questions about bullying, discrimination and loss of productivity.Results: AD negatively affected QoL in 51.6% of respondents, whereas 68.8% considered AD as a real limit to daily routine. More in detail, 39.3% of students were victims of bullying and 33.9% of workers felt discriminated because of AD. On average, absenteeism in students was for 17.1 days/year (presenteeism: 19.5 days/year), whereas in workers, the estimate was 10.9 days/year (presenteeism: 13.1 days/year). Absenteeism and presenteeism were more pronounced in bullied/discriminated subjects.Conclusion: AD multidimensional implications deeply affect and undermine personal and professional fulfillments. Our results contribute to a better understanding of what living with AD means.Keywords: atopic dermatitis, discrimination, absenteeism, presenteeism

Keywords

• atopic dermatitis
• discrimination
• absenteeism
• presenteeism