Prevalence and Burden of Atopic Dermatitis Involving the Head, Neck, Face, and Hand: A Cross Sectional Study from the TARGET-DERM AD Cohort

Document Type

Journal Article

Publication Date



Journal of the American Academy of Dermatology




Atopic Dermatitis (AD); Body Surface Area (BSA); Burden; Burden of Disease; Children’s Dermatology Life Quality Index (CDLQI); Dermatology Life Quality Index (DLQI); Face; Hands; Head; Neck; PO-SCORAD; Patient Reported Outcomes Measurement Information System (PROMIS); Patient-Oriented Eczema Measure (POEM); Prevalence; Quality of Life (QoL); adult; challenging; child; difficult; disease; longitudinal; observational; patient reported outcome (PRO); pediatric; real-world; severe; treatment; vIGA-AD TARGET-DERM; visible


BACKGROUND: AD is severely burdensome, and there has been poor characterization of any differences in impact based on the area affected. OBJECTIVE: To estimate the prevalence and HRQoL impact of Head/Face/Neck/Hand (HFNH) involvement among patients with moderate-to-severe AD. METHODS: All TARGET-DERM AD registry patients with moderate/severe Investigator Global Assessment (vIGA-AD) were assessed using the Patient Oriented SCORing Atopic Dermatitis, Patient Oriented Eczema Measure (POEM) and the (Children's) Dermatology Life Quality Index ((C)DLQI). RESULTS: 541 participants met criteria (75.0% adults) and 84% (N=453) reported HFNH involvement. HFNH and non-HFNH involved participants had similar characteristics; 55.2% female and 46.9% White. Compared to the non-HFNH involved, the involved had severe vIGA-AD (28.5% vs. 16.3%, p=0.02) and higher median body surface area affected (15% vs. 10%, p≤0.01) and were twice as likely to have higher (C)DLQI and POEM scores. LIMITATIONS: This was an analysis of real-world and patient reported outcome data. CONCLUSION: Real-world HFNH involved AD patients were associated with significantly worse quality of life, POEM/(C)DLQI, and more severe disease. Detailed assessments of specific areas affected by AD are needed to personalize treatment.