Anthropomorphizing Atopy: Tweeting about Eczema 1 Saheeda Thelwall, Mike Thelwall, University of Wolverhampton, UK. Atopic dermatitis or eczema affects a substantial minority of children and adults. Patients may treat their symptoms through skin care regimes and/or diet restrictions and/or prescribed topical corticosteroids. The patient perspective is important because of the long- term self-administered treatment regime and the potential psychological effects on relationships from a visible disease. This paper assesses the potential of public social media data to give new insights into patient perspectives through a thematic analysis of a random sample of 400 tweets from 2019 matching the query, “my eczema”. Whilst the most common use of Twitter is to announce a flare-up, it is also used to express anger and discuss possible treatments. New themes not previously reported include the use of humor to discuss the condition and giving eczema agency: discussing it as if it had a will of its own. These may be defense strategies against the potential of eczema to strike at any time or the fear of negative reactions or blame from friends. This highlights importance of nurses and others helping patients to deal with the psychological effects of eczema. Keywords: Atopic dermatitis; Eczema; Twitter; Social media; Patient perspectives. Introduction Atopic dermatitis or eczema is a complex skin condition that affects children and adults. It has varied clinical presentation but often causes itchy and dry skin with sore red patches, and typically varies in severity, including periods of remission. Whilst there is no cure, its symptoms can be treated with emollients or topical corticosteroids (Barfield, Brown, Pernell, & Woodard, 2017). As an allergic condition, those affected may gain relief by identifying and avoiding triggers or allergens. Eczema can be embarrassing when red patches are on visible parts of the skin and can be painful. The patient perspective is important for this condition because good skincare regimes are important for eczema management and symptoms may be distressing. In addition, adherence to recommended long-term emollient therapy regimes can be difficult, particularly for children (Santer, Burgess, Yardley, Ersser, Lewis‐Jones, Muller, & Little, 2013). The eczema patient perspective has been extensively analyzed through phone interviews with 48 adolescent and adult patients in the USA, producing a model of its symptoms and life burden (Grant, Larsen, Trennery, Silverberg, Abramovits, Simpson, & Bang, 2019). The main direct effects reported include itching, pain, and burning with red and dry skin, leading to indirect effects like discomfort and sleep disturbances. Patients also frequently reported embarrassment, anger, anxiety and other psychological impacts as well as restrictions to daily living and relationships. This creates a picture of a condition with extensive direct and indirect effects, reducing multiple quality of life dimensions. Social media can be exploited to gain new insights into patient perspectives when they are free to comment rather than responding to questions in interviews, surveys or focus groups (Hilton, 2017; Sarker, Magge, & Sharma, 2017; Robinson, Turk, Jilka, & Cella, 2019). For example, blogs mentioning topical steroid withdrawal in children with atopic dermatitis have been systematically surveyed for insights, in the absence of directly relevant 1 Thelwall, S. & Thelwall, M. (in press). Anthropomorphizing Atopy: Tweeting about Eczema. Journal of the Dermatology Nurses' Association.