Psycho-Social Impact of Atopic Dermatitis [Interview][Transcript]

dr_doris_day_atopic_dermatitisGuest: Dr. Doris Day
Presenter: Neal Howard
Guest Bio: Doris Day, MD, is a board certified dermatologist who specializes in laser, cosmetic and surgical dermatology on the Upper East Side in New York City. Her private practice includes national and international celebrities. Dr. Day is affiliated with Lenox Hill Hospital in New York City and is a clinical associate professor of dermatology at the New York University Langone Medical Centers where she was presented with the award for Dedication and Excellence in the Teaching of Dermatology.

Segment overview: Dr. Doris Day, MD, a board certified dermatologist talks about the physical and often profound psycho-social impact of Atopic Dermatitis.

Transcription
Health Professional Radio – Atopic Dermatitis

Neal Howard: Hello and welcome to the program, I’m your host Neal Howard here on Health Professional Radio. Thank you so much for joining us today. October is Eczema Awareness Month, our guess in studio is Dr. Doris Day returning to talk with us about the physical and often profound psychosocial impact of atopic dermatitis. Thank you so much for returning with us Dr. Day. You’re a board certified dermatologist, were you always a dermatologist? Is that something that you went into full force or did you kind of transitioned from maybe another specialty or another field altogether?

Dr. Doris Day: Actually I came from a family of doctors so it’s kind of in my blood and the assumption was that I would always be a doctor but I diverged along the way. So I studied philosophy and literature in college, did my pre-med after then I went to journalism school to be a medical journalist before then saying ‘Okay, yeah, actually I will be a doctor. You’re right it’s really what I want to do’ and it is my passion but I love that I have the background on the more humanities side because when you study literature and philosophy that’s really what drives people and drives disease and helps us understand how to be true healers rather than just prescribers really.

N: You’re mentioning I guess bedside manner for lack of a better term. When you’re dealing with the skin, we see the skin first, we see our faces, our arms. A problem with the skin such as atopic dermatitis which is a form of eczema. Let’s talk about some of the effects that you’ve seen in your experience when it comes to diseases of the skin and how they affect patients.

D: Well the skin is really your most powerful influencer and is a powerful reflection of your overall health and wellbeing. And what I love about being a dermatologist is that I can tell so much about a patient with that from just looking at them and watching their body language and studying and analyzing their skin and sometimes patients think of us as psychics because we seem to know so much about them and we really know very little but the skin gives us a lot of clues that we can tell if someone is prone to heart disease or liver disease or kidney disease just because of things we see in the skin, hair and nails. So the issue becomes when somebody has a chronic illness, something like atopic dermatitis that tends to be chronic and that has an impact on them both physically but also almost even more so emotionally because there is no cure for it, it’s really just a matter of control and the triggers can sometimes just surprise them and catch them off-guard and it’s very uncomfortable to have to live with something that you’ll never know, it’s like a ticking time bomb and you never know when it’s going to go off.

N: So you just say there’s no cure for atopic dermatitis. What type of disorder is this? Are we talking a virus or are we talking something that is transmissible? What’s the nature of this condition?

D: It’s not contagious, it’s not transmissible but it is immune related and it can be genetic as well. We do see it running in families and something that can happen in childhood, it can happen in any age, anywhere you have skin, it sometimes something that people grow out off and sometimes something they grow into as an adult and it is what I call an itch that rashes. It starts out typically as a severe itch that can have burning and then you can’t resist scratching, it’s really just impossible to resist going after it and that scratching helps bring out the rash. The rash can be oozing, thicken skin that again stings and burns but it’s not something that can spread, and it’s not contagious. Once the skin is not healthy and intact it can be…really inspected but otherwise it’s not contagious.

N: Well being the skin, I mean if it occurs say in a school-age kid, we’re talking problems with physical education classes or maybe problems playing sports or possibly even with the type of clothes that you’d have to wear, we’re talking possibly some major lifestyle changes.

D: Absolutely, that’s exactly true sometimes they’re very limited into what they can wear and the type of activities they do. If heat is a trigger or friction is a trigger and sometimes other kids or adults even look at them and think they have something contagious and are very quick to judge and people can feel ostracized by having something that’s so visible and so unsightly sometimes even though it’s not contagious anyway.

N: Is AD the most severe type of eczema or are we talking about several different types of eczema some being a little bit more I guess readily controllable than others?

D: It’s different for different people but atopic dermatitis is a chronic form of eczema and there is a type that’s moderate to severe and that’s really the type that has the greatest impact.

N: We were talking about school aged kids but when it comes to dealing on the job, have you seen instances where a person may switch careers because of a lifestyle change? Because of uniforms or because of the type of environment that their job offers them and now they’ve come up with AD and they have to change their job?

D: Well actually in the study 82% of respondents said that they had to make lifestyle modifications because of their moderate to severe atopic dermatitis and for some of these if it’s on your hands and you have to shake hands regularly or work with your hands if you’re a chef or if you are an artist or anything that’s going to have exposure in that way, absolutely it’s a problem. If you’re an athlete and it’s on parts of your body where if you’re going to have friction from the clothing and you’re required to wear a certain uniform that can have an impact as well. If it’s on your scalp and that can just have an impact of just going out with just the itch and the pain of it just, literally leaving the house can become a problem. So this is depending on the part of the body and the exposure and how visible it is, it can have a very dramatic impact on the type of job someone goes into or their overall lifestyle choices.

N: I understand that you’re involved in a campaign to I guess better understand atopic dermatitis, could you talk about that campaign just a bit?

D: Yup, atopic dermatitis the Understand AD is a campaign to really just open up a dialogue to help those patients and professionals understand that this is a serious condition. That it affects 1.6 million people, adults with moderate to severe uncontrolled atopic dermatitis, that’s a lot of people and it’s something that we need to pay attention to and help patients understand that they’re not alone if they have this and that there are some area of very active research and there are things that we can do to help them control and manage their condition even if we can’t cure it.

N: What about support from your family members who need some understanding themselves? It’s one thing to educate your health care provider or maybe some teachers, but what about your support system at home, your kids, your spouse? Are there any resources that you can recommend where we can better understand other than understand AD, is that part of the National Eczema Association?

D: Yeah it is and also with understandad.com there some information there. There are support groups, there’s the Eczema Association as well. So there’s a lot that someone can do who has this to realize that they’re not alone and learn some tips and tricks of how to manage it best.

N: Well it’s been great having you here with us in studio today Dr. Day and I’m hoping that you’ll come back and talk with us some more about atopic dermatitis.

D: Absolutely, I’d look forward to it. Thank you.

N: Thank you. You’ve been listening to Health Professional Radio. I’m your host Neal Howard in studio this afternoon with Dr. Doris Day, board certified dermatologist in studio discussing some of the often profound psychosocial impacts of atopic dermatitis. Transcripts and audio of this program are available at healthprofessionalradio.com.au and also at hpr.fm and you can subscribe to this podcast on iTunes.

Liked it? Take a second to support healthprofessionalradio on Patreon!