Clinical Characteristics of Cutaneous Pain in Atopic Dermatitis: a Cross-Sectional Prospective Study

Introduction: Atopic dermatitis (AD) is a chronic inflammatory skin disease often associated with itch and pain. Objectives: This exploratory study aimed to describe the prevalence, intensity, and associations of cutaneous pain in AD. Methods: This cross-sectional study with prospective data collection included 121 patients with AD (61% female; mean age 34.29 ± 12.56 years). Disease severity was assessed using the Eczema Area and Severity Index (EASI). Cutaneous pain was evaluated using the Numerical Rating Scale (NRS), short-form McGill Pain Questionnaire (SF-MPQ), Visual Analogue Scale (VAS), and Douleur Neuropathique-4 Questionnaire (DN4). Results: Cutaneous pain was reported by 82 patients (67.8%) during the past week, with a mean NRS score of 3.57 ± 3.14. Women reported significantly higher pain scores on the NRS (p = 0.025), SF-MPQ (p = 0.034), sensory subscale (p = 0.027), and VAS (p = 0.035). Probable neuropathic pain was reported by 55 patients (45.5%). Univariate analysis showed correlations between pain severity and age (r = 0.194, p = 0.033), lifetime NRS pain (r = 0.370, p < 0.001), DN4 (r = 0.567, p < 0.001), SF-MPQ total (r = 0.856, p < 0.001), sensory (r = 0.846, p < 0.001), affective (r = 0.730, p = 0.007), VAS (r = 0.943, p < 0.001), and EASI (r = 0.458, p < 0.001). Conclusions: Cutaneous pain was common in AD and associated with female sex, age, and disease severity. Nearly half reported probable neuropathic pain, more frequently among women. Given the univariate analysis and absence of multiple-comparison correction, findings are hypothesis-generating and require confirmation.