Amy Paller, M.D., on How Atopic Dermatitis Disrupts Families
The PEDISTAD registry reveals that pediatric atopic dermatitis significantly affects not just children but their families, with sleep loss and emotional strain among the most reported challenges.
By
Lana Pine
| Published on June 13, 2025
2 min read
In a recent discussion, Amy S. Paller, M.D., professor of dermatology at Northwestern University Feinberg School of Medicine, chair of the Department of Dermatology and director of the Skin Biology and Diseases Resource-Based Center, shared key insights from PEDISTAD — a global, 10-year observational registry that is deepening our understanding of pediatric atopic dermatitis (AD). The registry focuses exclusively on children under the age of 12, with growing interest in those under 6, and collects real-world data on disease burden, treatment patterns and impacts on family life.
Paller emphasized that PEDISTAD is not just tracking clinical outcomes but also revealing the significant emotional and logistical burden AD places on families. Disease severity is captured through both physician-assessed measures (such as the Eczema Area and Severity Index [EASI]) and parent-reported tools (including the Patient-Oriented Eczema Measure [POEM]). To assess family impact, the registry uses the Dermatitis Family Impact (DFI) score.
Findings from the registry so far show that many enrolled children have moderate to severe disease, with an average body surface area involvement in the 30% range — a substantial burden. But what’s most striking is how consistently high the DFI scores are across age groups. A large proportion of families reported a moderate to high impact on daily life due to their child’s condition.
One of the most powerful reflections of this burden, according to Paller, is sleep disruption — not just for the child, but for the entire household. Parents often co-sleep or stay awake soothing their children to prevent scratching and distress. This chronic sleep deprivation can deeply affect family functioning and mental health.
Paller underscored how important it is to ask families not only about the child’s symptoms but also about how they are coping. A simple question like “Are you getting any sleep?” often opens the door to stories of stress, exhaustion and, finally, relief when effective treatment improves the child’s condition. She notes that families visibly brighten when they report better sleep — a clear signal that life has changed for the better.
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