To the Editor: Effective pediatric atopic dermatitis (AD) care requires families to understand the treatment plan.1 Clinicians face time constraints that limit comprehensive patient education,2 underscoring the need for supplementary educational resources.3
This study evaluates whether a 7-minute-long animated educational video enhances disease outcomes in pediatric AD. A script was written by pediatric dermatologists at Hadassah Medical Center and then animated by Silueta Productions (Tel Aviv).
We performed a prospective observational frequency-matched case-control trial involving children with AD aged 2 months to 18 years at 2 tertiary medical centers in Israel, following approval by local institutional review boards.
AD diagnosis was confirmed by certified dermatologists using the American Academy of Dermatology diagnostic criteria.4 Children attending their first visit for AD were included. We excluded patients receiving systemic treatment (methotrexate, cyclosporine, azathioprine, mycophenolate mofetil, dupilumab, upadacitinib, and systemic corticosteroids).
Outcome measures were disease severity (eczema area and severity index [EASI] and scoring atopic dermatitis [SCORAD]), pruritus (peak pruritus numerical rating scale), and quality of life (children dermatology life quality index [CDLQI]).
Participants were matched into 2 groups by age, gender, and disease severity scores and were given an oral and written treatment plan based on the Consensus-based European guidelines for treatment of AD.5 The study group was emailed a link to the video and was encouraged to watch it weekly for the first month. Parents were required to watch the video; if the child was old enough, he was encouraged to watch it as well.
Participants were followed up in clinic or via teledermatology at 1 month and 3 months, and SCORAD, EASI, pruritus numerical rating scale, and CDLQI were assessed.
Descriptive statistics were used to display results. Categorical variables were compared by the χ2 test, and continuous variables by Student t test or ANOVA for repeated measures. Analysis was performed using SPSS (version 25.0).
Fifty children were recruited in each group. Seventy-five patients attended at least 1 follow-up visit, 40 in the video group and 35 in the control group. Demographics are presented in Table I. At the first visit, there were no statistically significant differences between the groups (Table II), although all scores tended to be higher in the video group.
Table I.
Demographics and baseline clinical characteristics of study participants
| Variable group | Video | Control | P value |
|---|---|---|---|
| Gender (male), M (%) | 30 (73) | 22 (54) | .109 |
| Age, M (SD) | 39.9 (44.4) | 49.9 (47.8) | .326 |
Table II.
Disease severity scores
| Variable group | Video |
Control |
Effect size | P value | ||
|---|---|---|---|---|---|---|
| V1 | V3 | V1 | V3 | |||
| EASI∗ | 15.4 (12.5) | 2.3 (2.8) | 10.5 (9.6) | 4.0 (8.3) | .089 | .008 |
| SCORAD∗ | 48.3 (19.7) | 13.3 (11.7) | 42.1 (18.0) | 21.0 (15.8) | .116 | .002 |
| CDQLI∗ | 10.5 (5.6) | 3.0 (4.2) | 9.0 (5.8) | 4.7 (4.3) | .094 | .007 |
| pNRS∗ | 6.6 (2.9) | 2.3 (2.9) | 5.8 (2.8) | 3.2 (2.9) | .062 | .030 |
pNRS, Pruritus numerical rating scale; V1, visit 1; V3, visit 3.
Two-way ANOVA for repeated measures. Effect size–Partial Eta squared.
In both groups, EASI, SCORAD, and CDLQI scores improved significantly over time, improvement was significantly greater in the video group compared to the control group at the third visit versus baseline (Table II, Supplementary Fig 1, available via Mendeley at https://doi.org/10.17632/zbkj9pg26y.1). Pruritus improved significantly better in the video group compared to the control group only between the first and second visits (P value = .022).
Our animated video is a valuable tool for improving AD severity and quality of life over the course of 3 months in a pediatric AD population.
It is available on YouTube in English, Hebrew, and Arabic (QR codes are available below).
A limitation of our study is that the study group received the video by email. Some parents used the email to request extra guidance, which may have affected compliance.
The video could be a time-saving tool for physicians treating children with AD and can serve as an aid in improving AD outcomes.
The video can be accessed here:
In English: https://youtu.be/N1mfeETSNkQ.
In Hebrew: https://youtu.be/NcEXgEkBSZI.
In Arabic: https://youtu.be/AKSllcbMm8M.
Declaration of generative AI and AI-assisted technologies in the writing process
During the preparation of this work, the author(s) used [ChatGPT] in order to adjust the style and format of the manuscript to those required by JAAD International. After using this tool/service, the author(s) reviewed and edited the content as needed and take(s) full responsibility for the content of the published article.
Conflicts of interest
None disclosed.
Acknowledgments
We thank Pfizer pharmaceuticals for grants supporting the production of the animated video and the conduction of this study. We also thank Dr Dvora Rotnemer, our research coordinator, and our patients and their parents who participated in this study.
Footnotes
Funding sources: The production of the educational video and study was supported by an educational grant from Pfizer.
Patient consent: There are no recognizable patient photographs or other identifiable material in this manuscript that requires consent to be obtained from participants to publish this study.
IRB approval status: The study was approved by the IRB at both hospitals where the patients were examined. IRB Approval Hadassah Hospital-HMO-20-0194, IRB Approval Sheba-Tel Hashomer Medical Center SMC-20-7679.
This work has been presented at the annual conference of the Israel Dermatologic Association in May 2024 and as an e-poster at the European Academy of Dermatology and Venereology in September 2025.
References
- 1.Fischer G. Compliance problems in paediatric atopic eczema. Australas J Dermatol. 1996;37(Suppl 1):S10–S13. doi: 10.1111/j.1440-0960.1996.tb01070.x. [DOI] [PubMed] [Google Scholar]
- 2.Prasad K., Poplau S., Brown R., et al. Healthy Work Place HWP Investigators Time pressure during primary care office visits: a prospective evaluation of data from the healthy work place study. J Gen Intern Med. 2020;35(2):465–472. doi: 10.1007/s11606-019-05343-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Cork M.J., Britton J., Butler L., Young S., Murphy R., Keohane S.G. Comparison of parent knowledge, therapy utilization and severity of atopic eczema before and after explanation and demonstration of topical therapies by a specialist dermatology nurse. Br J Dermatol. 2003;149(3):582–589. doi: 10.1046/j.1365-2133.2003.05595.x. [DOI] [PubMed] [Google Scholar]
- 4.Eichenfield L.F., Tom W.L., Chamlin S.L., et al. Guidelines of care for the management of atopic dermatitis: section 1. diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol. 2014;70(2):338–351. doi: 10.1016/j.jaad.2013.10.010. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Wollenberg A., Barbarot S., Bieber T., et al. European Dermatology Forum EDF, the European Academy of Dermatology and Venereology EADV, the European Academy of Allergy and Clinical Immunology EAACI, the European Task Force on Atopic Dermatitis ETFAD, European Federation of Allergy and Airways Diseases Patients’ Associations EFA, the European Society for Dermatology and Psychiatry ESDaP, the European Society of Pediatric Dermatology ESPD, Global Allergy and Asthma European Network GA2LEN and the European Union of Medical Specialists UEMS Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I. J Eur Acad Dermatol Venereol. 2018;32(5):657–682. doi: 10.1111/jdv.14891. [DOI] [PubMed] [Google Scholar]