Jacob S Margolis1, Katrina Abuabara2, Warren Bilker1, Ole Hoffstad1, David J Margolis2. 1. Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia. 2. Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia2Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia.
Abstract
IMPORTANCE: Atopic dermatitis (AD) is a common illness of childhood. OBJECTIVE: To evaluate the natural history of AD and determine the persistence of symptoms over time. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional and cohort study of a nation-wide long-term registry of children with AD enrolled in the Pediatric Eczema Elective Registry (PEER). MAIN OUTCOMES AND MEASURES: Self-reported outcome of whether a child's skin was AD symptom-free for 6 months at 6-month intervals. RESULTS: A total of 7157 patients were enrolled in the PEER study for a total of 22,550 person-years. At least 2 years of follow-up were observed for 4248 children and at least 5 years of follow-up were observed for 2416 children. Multiple demographic and exposure variables were associated with more persistent AD. At every age (ie, 2-26 years), more than 80% of PEER participants had symptoms of AD and/or were using medication to treat their AD. It was not until age 20 years that 50% of patients had at least 1 lifetime 6-month symptom- and treatment-free period. CONCLUSIONS AND RELEVANCE: Based on this large longitudinal cohort study, symptoms associated with AD seem to persist well into the second decade of a child's life and likely longer. Atopic dermatitis is probably a life-long illness.
IMPORTANCE: Atopic dermatitis (AD) is a common illness of childhood. OBJECTIVE: To evaluate the natural history of AD and determine the persistence of symptoms over time. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional and cohort study of a nation-wide long-term registry of children with AD enrolled in the Pediatric Eczema Elective Registry (PEER). MAIN OUTCOMES AND MEASURES: Self-reported outcome of whether a child's skin was AD symptom-free for 6 months at 6-month intervals. RESULTS: A total of 7157 patients were enrolled in the PEER study for a total of 22,550 person-years. At least 2 years of follow-up were observed for 4248 children and at least 5 years of follow-up were observed for 2416 children. Multiple demographic and exposure variables were associated with more persistent AD. At every age (ie, 2-26 years), more than 80% of PEER participants had symptoms of AD and/or were using medication to treat their AD. It was not until age 20 years that 50% of patients had at least 1 lifetime 6-month symptom- and treatment-free period. CONCLUSIONS AND RELEVANCE: Based on this large longitudinal cohort study, symptoms associated with AD seem to persist well into the second decade of a child's life and likely longer. Atopic dermatitis is probably a life-long illness.
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