Harrison H Lee1, Kevin R Patel1, Vivek Singam1, Supriya Rastogi1, Jonathan I Silverberg2. 1. Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois. 2. Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Northwestern Medicine Multidisciplinary Eczema Center, Chicago, Illinois. Electronic address: jonathanisilverberg@gmail.com.
Abstract
BACKGROUND: Previous studies found conflicting results about whether atopic dermatitis (AD) begins in adulthood. OBJECTIVE: To determine rates, predictors, and phenotypic differences of adult-onset AD. METHODS: A systematic review was performed with all published observational studies in Medline, Embase, GREAT (Global Resource of EczemA Trials), LILACS (Latin American and Caribbean Health Sciences Literature), Cochrane Library, and Scopus that analyzed the age of AD onset beyond 10 years of age. At least two reviewers performed study title, abstract review, and data extraction. Pooled meta-analysis of the proportion of adult-onset AD was performed by using random-effects weighting (I2 = 99.3%). RESULTS: Overall, 25 studies met inclusion criteria. Seventeen studies reported age of AD onset as after 16 years of age and had sufficient data for meta-analysis. The pooled proportion (95% confidence interval) of adult-onset AD was 26.1% (16.5%-37.2%). Similar results were found in sensitivity analyses by AD diagnostic method, study region, and sex. Phenotypic differences were observed across studies for adult-onset and child-onset AD, including higher rates of foot dermatitis and personal history of atopy but lower rates of flexural lesions and other signs and symptoms. LIMITATIONS: Characteristics of adult-onset versus child-onset AD were not commonly reported. CONCLUSION: AD is not only a disease of childhood; 1 in 4 adults with AD report adult-onset disease, which has distinct clinical characteristics as compared to child-onset AD.
BACKGROUND: Previous studies found conflicting results about whether atopic dermatitis (AD) begins in adulthood. OBJECTIVE: To determine rates, predictors, and phenotypic differences of adult-onset AD. METHODS: A systematic review was performed with all published observational studies in Medline, Embase, GREAT (Global Resource of EczemA Trials), LILACS (Latin American and Caribbean Health Sciences Literature), Cochrane Library, and Scopus that analyzed the age of AD onset beyond 10 years of age. At least two reviewers performed study title, abstract review, and data extraction. Pooled meta-analysis of the proportion of adult-onset AD was performed by using random-effects weighting (I2 = 99.3%). RESULTS: Overall, 25 studies met inclusion criteria. Seventeen studies reported age of AD onset as after 16 years of age and had sufficient data for meta-analysis. The pooled proportion (95% confidence interval) of adult-onset AD was 26.1% (16.5%-37.2%). Similar results were found in sensitivity analyses by AD diagnostic method, study region, and sex. Phenotypic differences were observed across studies for adult-onset and child-onset AD, including higher rates of foot dermatitis and personal history of atopy but lower rates of flexural lesions and other signs and symptoms. LIMITATIONS: Characteristics of adult-onset versus child-onset AD were not commonly reported. CONCLUSION:AD is not only a disease of childhood; 1 in 4 adults with AD report adult-onset disease, which has distinct clinical characteristics as compared to child-onset AD.
Authors: Katrina Abuabara; Morgan Ye; Charles E McCulloch; Alice Sullivan; David J Margolis; David P Strachan; Lavinia Paternoster; Yik Weng Yew; Hywel C Williams; Sinéad M Langan Journal: J Allergy Clin Immunol Date: 2019-06-28 Impact factor: 10.793
Authors: Deanna E Morra; Eunyoung Cho; Tricia Li; Carlos A Camargo; Abrar A Qureshi; Aaron M Drucker Journal: J Am Acad Dermatol Date: 2020-07-23 Impact factor: 11.527