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- Presentation
Epidemiology of Atopic Dermatitis Across the Life Course and Its Comorbidities
Description
The speaker reviews the epidemiology of atopic dermatitis across the life course and highlights clinically relevant comorbidities. Atopic dermatitis is common in both children and adults, with prevalence estimates varying by how it is measured; most affected children have mild disease, while adults are more likely to have moderate to severe disease. Contrary to older assumptions, many children do not outgrow eczema, and persistence into adulthood is more common than previously thought, especially among those with more severe disease, personal or family history of atopy, or belonging to marginalized communities. Adult-onset atopic dermatitis is also real, and there may even be a second peak in older adults. The talk then addresses comorbidities: depression and anxiety are associated with atopic dermatitis in a severity-dependent way, and effective treatment can improve these mental health symptoms. Cardiovascular risk is more controversial but may be relevant when choosing therapies, particularly in patients with additional risk factors. Eczema has also been linked with fractures, potentially due in part to cumulative steroid exposure, so clinicians should consider bone health and preventive care when appropriate.
View moreConclusions
- Atopic dermatitis is common across the lifespan, including in adults, and its burden is substantial.
- Childhood atopic dermatitis often persists into adulthood more than previously believed, especially in patients with personal or family atopy and in marginalized communities.
- A meaningful fraction of eczema begins in adulthood, and there may be a second peak of disease in older adults.
- Most childhood cases are mild, but adults more often have moderate to severe disease.
- Effectively treating atopic dermatitis can improve associated mental health symptoms such as anxiety and depression.
- Cardiovascular comorbidity is likely a real but low-absolute-risk association that may influence systemic treatment choice in higher-risk patients.
- Atopic dermatitis is associated with increased fracture risk, particularly with more severe disease and cumulative oral corticosteroid exposure.
- Comorbidity assessment should be part of routine clinical decision-making for atopic dermatitis, not just an epidemiologic curiosity.
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