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Atopic Dermatitis

Disease Awareness

Read time: 40 mins
Last updated:26th Jun 2020
Here, we introduce atopic dermatitis from an epidemiological perspective and expand on its symptoms, burden of disease and diagnosis. The pathophysiology of atopic dermatitis is also discussed as it relates to the mode of action of some treatments, including anti-interleukins and PDE4 inhibitors.

Epidemiology

Prevalence and incidence of atopic dermatitis

Atopic dermatitis, or atopic eczema, is the most common chronic skin condition and is characterised by acute episodes of eczematous, pruritic lesions over dry skin. 

It typically starts in early childhood and is widely reported to affect 15–20% of children and 1–3% of adults1.

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Symptoms

Atopic dermatitis, also called atopic eczema or eczema, is an inflammatory, chronic or chronically relapsing skin disease with pruritus as the predominant dermatological symptom36,59,83.

The condition typically presents in infancy, with 60% of cases occurring within the first year, however, it can develop in older patients with approximately one third of adult cases developing in adulthood36,83. Over time, the clinical presentation of atopic dermatitis changes36.

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Burden of atopic dermatitis

As a chronic, relapsing skin condition, atopic dermatitis has a significant impact on patients’ quality of life. 

However, given the age of most patients, and the fact that it can persist into adulthood, atopic dermatitis also places a heavy burden on patients’ family as well as society (Avena-Woods, 2017). 

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Pathophysiology of atopic dermatitis

A complex range of factors influence the development and onset of atopic dermatitis, but what is the underlying mechanism that drives skin barrier dysfunction and inflammation? Discover how breakdown of the skin barrier can lead to allergen penetration and immune system activation.

Pathogenesis

In the past, atopic dermatitis was thought to be primarily a consequence of immune dysfunction in susceptible children. However, recent advances point towards a complex pathophysiology with genetic, barrier function, immunity and environmental factors acting together and synergistically to drive barrier dysfunction, inflammation and disease progression25.

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Diagnosing atopic dermatitis

Diagnosis of atopic dermatitis relies strongly on clinical presentation and is typically made through an extensive history and physical examination2. 

Several classification criteria have been developed, but the Hanifin and Rajka criteria originally developed in 1980 remain the most widely used worldwide83.

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References

1. Nutten S. Atopic dermatitis: Global epidemiology and risk factors. Ann Nutr Metab. 2015;66:8–16.

2. Avena-Woods C. Overview of atopic dermatitis. Am J Manag Care. 2017;23(8):S115–S123.

3. Silverberg JI, Simpson EL. Association between severe eczema in children and multiple comorbid conditions and increased healthcare utilization. Pediatr Allergy Immunol. 2013;24(5):476–486.

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