למה אנחנו צריכים טיפול טוב יותר לאנשים עם אקזמה

Around 1.5 million people live with moderate or severe אקזמה in the UK. However, a recent דוח by Allergy UK and Sanofi highlights a number of problems they face when trying to access care.

National Institute for Health and Care Excellence (NICE) guidelines are evidence-based recommendations for health and care in England. Yet for adolescents and adults with אקזמה, there are no standardised guidelines to reduce the variation of timely care and treatment seen across the country. As a result, nearly half of the healthcare professionals surveyed in the report, including GPs and dermatologists, said they did not have clear guidance and support around when to diagnose and refer people with severe אקזמה.

The impact of this for people with eczema is far-reaching. More than 50% wait more than a year for a treatment regime that makes their condition manageable, with over 75% saying eczema had impacted their בריאות הנפש. המצב גם משבש את חיי היומיום עבור אנשים רבים, כאשר כמעט 25% מהמבוגרים עם אקזמה לוקחים יותר מ-15 ימי חופש מהעבודה בשנה עקב האקזמה שלהם.

Although the report highlights that these issues existed before the pandemic, COVID-19 has had an impact on care and treatment too. Almost half of patients surveyed said COVID-19 has made it more difficult to access services and treatments, while 87% of healthcare professionals say the pandemic has made it harder to identify patients.

לא תמיד מתייחסים לאקזמה ברצינות

Dr Adil Sheraz, a consultant dermatologist and קרן העור הבריטית spokesperson, says it's important that patients are assessed carefully in primary care, both for their skin issues but also for the impact the condition has on their mental well-being.

"Unfortunately on many occasions patients are asked to just 'stop scratching' or are not taken seriously as it's perceived as 'just' a מצב עור," הוא אומר.

"For most patients, eczema tends to be something that they have lived with for most of their lives," Sheraz adds. "In the case of adults with אקזמה, לעיתים קרובות אני מקבל את הרושם שכאשר מטופלים מגיעים למרפאת עור מומחית, הם מופתעים לגלות שישנן אפשרויות אחרות מלבד סטרואידים מקומיים לטיפול באקזמה."

Eczema is a relapsing and remitting condition, which means that there will be periods when a short course of topical בסטרואידים use will clear the skin. The patient may remain in remission for many months before their eczema symptoms return. "Occasionally it may also take some time to build up to a treatment regime that works for the patient," says Sheraz.

Eczema can have a serious impact on people's physical and בריאות הנפש. Adequate psychological support for people with eczema is essential. As well as treating the physical symptoms of eczema, interventions such as ייעוץ allow people to cope better with the mental impact of their condition.

"לחיות עם אקזמה יכול להשפיע באופן עמוק על הבריאות הנפשית של האדם. זה חיוני לחלוטין שהמטופלים שיש להם אקזמה ומתקשים פיזית או נפשית כתוצאה מכך יופנו לרופא עור כדי להתחיל בטיפול מוקדם," אומר שרז.

"We must not forget the impact that אקזמה will have on family members, particularly in the case of children, who may be up all night scratching, resulting in tired and weary parents. There are also some schools of thought that early, effective intervention and treatment of eczema may help prevent the development of other conditions such as אלרגיות למזון or allergic rhinitis," he adds.

"טיפולים מוקדמים ויעילים יובילו גם להפחתה בהתפרצויות עור, פחות ביקורים אצל רופאים ובבתי חולים, וצורך מופחת באשפוז מטופלים."

ה מחקר in the British Journal of Dermatology revealed that atopic eczema has a significant detrimental impact on patients' quality of life. When looking at the Children's Life Quality Index - a measure used to assess the impact of any condition on quality of life - eczema had the second highest score, surpassed only by שיתוק מוחין.

"From a physical perspective the skin of course is extremely itchy, can burn or become infected. Sleep is often disturbed, leading to further עייפות and physical רגשי," אומר שרז. "גורם שלעתים קרובות מתעלמים ממנו באקזמה חמורה הוא הכאב שיכול להיות קשור לעור מודלק. עם הזמן העור יכול להתעבות, לשנות צבע או להצטלק. התנהגות הגירוד מחמירה כאשר המטופלים מתוסכלים או לחוצים."

ה של האגודה הלאומית לאקזמה גילה שיותר מ-30% מהאנשים עם אקזמה אובחנו עם by the National Eczema Association revealed that more than 30% of people with eczema were diagnosed with דיכאון או חרדה. Additionally, research published in JAMA dermatology in 2018 showed a significant increase in risk of מחשבות אובדניות in adults with eczema when compared to the general population.

"The impact that moderate-to-severe אקזמה continues to have on people's lives is laid out here in stark terms," says Carla Jones, CEO of Allergy UK. "Yet still, a very small percentage of Integrated Care Systems (ICSs) and their predecessors, Clinical Commissioning Groups (CCGs), have an eczema commissioning policy in place. And there is still no NICE adolescent or adult guidelines for eczema to help reduce unwarranted variation in care."

באמצעות מתן הנחיות אלו, אנשי מקצוע בתחום הבריאות יוכלו לתמוך טוב יותר בחולים עם אקזמה.