Atopic Dermatitis Study

Got Atopic Dermatitis or Eczema? You may qualify for a research study.

Below is a pre-screening survey to help us determine your qualification in one of our studies. You may stop the survey at anytime. All information provided is confidential.

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* 1. What is your first name?

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* 2. What is your last name?

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* 3. Phone Number:

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* 4. Email:

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* 5. Are you at least 18 years of age?

Yes

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* 6. Have you had a medical diagnosis of atopic dermatitis for at least 1 year?

Yes

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* 7. If female, are you pregnant or planning a pregnancy or nursing?

Yes

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* 8. On a scale from 0-10 where 0 is no itch at all and 10 is the worst itch imaginable, how much does your eczema/atopic dermatitis itch?

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* 9. On an average day how much Eczema/Atopic Dermatitis do you visibly have covering your Body Surface Area (your entire body)? (Using your palm to measure, Your palm=1% Body Surface Area)

I have less than 5% Eczema/Atopic Dermatitis

I have less than 10% Eczema/Atopic Dermatitis

I have greater than 10% Eczema/Atopic Dermatitis

I have greater than 30% Eczema/Atopic Dermatitis

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* 10. Which therapies are you currently using for your Atopic Dermatitis or Eczema?

Topical Medications (Over the counter)

Topical Medications (Prescription)

Antihistamines

Tablets

None

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* 11. Have you had problems treating your eczema/atopic dermatitis with creams or ointments containing steroids, either because it did not work well enough or because of side effects?

Yes

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* 12. In a clinical research trial, would you be willing to receive injections to treat your eczema/atopic dermatitis?

Yes

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* 13. Have you participated in a research study within the last 30 days?

Yes