The Cost of Relief: Financial and Educational Impacts on Atopic Dermatitis Care
Atopic Dermatitis (AD) affects those of all ages and demographics. AD is known to be cumbersome and financially taxing, significantly affecting patients’ quality of life (QoL). The purpose of this study is to assess the financial implications across various socioeconomic backgrounds and community types from the patient perspective within a single institution in the Southeastern U.S. A cross-sectional survey was administered to those ≥18 years old diagnosed with AD. Patients self-reported information on their socioeconomic status (SES), education level, affordability, expenses related to their AD, and factors affecting their QoL. In our cohort of sixty-four patients, we found that one in five patients have been unable to afford treatment at some point. This finding is not confined to the lowest income group, but rather all groups have experienced affordability difficulty. It is clinically significant that patients chose financial burden, transportation and access to medical care as one of their top three factors that decreased their QoL. We also found that the understanding of disease and treatment options may not be based on education level. Understanding the socioeconomic impact of disease facilitates ber resource allocation and knowledge of how we can better serve the evolving patient population.
DOI: 10.29245/2767-5092/2025/2.1198 View / Download PdfSuccessful Use of Combination 5% Fluorouracil and 0.005% Calcipotriene Cream for Peri-Anal HSIL and SCCIS in an HIV-Positive Patient
Purpose:
The management of multifocal perianal high-grade squamous intraepithelial lesion (HSIL) and squamous cell carcinoma in situ (SCCIS) remains challenging, especially in immunosuppressed populations such as individuals with HIV. Current treatments are often invasive and associated with high recurrence rates. This case report explores the use of combination 5% fluorouracil and 0.005% calcipotriene cream (5FU/C) as a non-invasive therapeutic alternative for recurrent perianal HSIL and SCCIS.
Methods:
We present a case of a 57-year-old HIV-positive male on antiretroviral therapy with recurrent HSIL and SCCIS involving the perianal, gluteal, perineal, and inguinal regions. After failing multiple surgical excisions, the patient was treated with 5FU/C cream applied topically twice daily for 8 days.
Results:
The patient experienced a strong inflammatory response and discontinued therapy prior to the recommended 10-day course. However, at 1-month follow-up, there was complete clinical resolution of external lesions. Four months later, internal recurrence was detected via digital rectal exam and high-resolution anoscopy, but external lesions remained clear. Biopsies confirmed HSIL without invasive disease.
Conclusion:
This case illustrates the potential of 5FU/C as a non-invasive treatment option for extensive external HSIL and SCCIS in immunocompromised patients. While external lesion resolution was achieved, internal disease recurrence at 4 months after 5-FU/C treatment emphasizes the importance of comprehensive internal evaluation. These findings support further investigation of 5FU/C as an adjunct or alternative to surgical treatment in the multidisciplinary management of anal neoplasia.
DOI: 10.29245/2767-5092/2025/2.1199 View / Download Pdf