https://doi.org/10.1177/1203475418805709
Journal of Cutaneous Medicine and Surgery
2018, Vol. 22(1S) 17S–20S
© The Author(s) 2018
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DOI: 10.1177/1203475418805709
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Atopic diseases are very common in both children and adults,
and while both incidence and prevalence are well docu-
mented in children, the true prevalence of these diseases is
less well known in the adult population. Most cases of atopic
dermatitis (AD) are commonly believed to be early onset,
appearing in the first 2 years of life and improving with age.
1
In the United States, self-reported pediatric AD is reported to
be 10.7%.
2
In contrast, adult-onset AD is thought to be much
less common, and few epidemiological studies have docu-
mented its prevalence.
1
Importantly, rates of AD prevalence
in adults vary widely depending on geography, likely due to
varied diagnostic criteria and international differences in
clinical phenotype.
Several publications have attempted to document the true
prevalence of AD in adults. Using population-based data
from the US National Center for Health Statistics and the
Centers for Disease Control and Prevention, the prevalence
of eczema was found to be 10.2% in adults.
3
Furthermore, a
3.2% prevalence of eczema, asthma, and hay fever was iden-
tified, suggesting AD is not uncommon in adult patients.
3,4
A
large, international, web-based survey done in the United
States, Canada, Europe, and Japan showed patient-reported
rates of adult AD between 2.1% and 4.9%, most commonly
of mild-to-moderate severity.
5
Of note, the point prevalence
of AD in Canada was found to be 3.5%. A population-based
Italian study estimated an 8.1% prevalence of self-reported
eczema, with a 3.4% prevalence of eczema with asthma and/
or hay fever. Prevalence was significantly associated with
environmental factors, which included living close to indus-
trial plants and high levels of heavy traffic near home.
6
Interestingly, a recent systematic review and meta-analysis
suggests that there is no significant difference in AD preva-
lence before and after childhood.
7
This may be due to persis-
tent disease, remission, or clearance of disease among some
patients and late-onset disease in others.
AD is often associated with other atopic diseases and may
occur as part of the atopic march. Atopic diseases include
asthma, allergic rhinitis, atopy-associated eye disorders
including allergic conjunctivitis and keratoconjunctivitis,
Original Article
805709CMS XX X 10.1177/1203475418805709Journal of Cutaneous Medicine and SurgeryHong et al
research-article 2018
Affiliations/acknowledgments: This paper is part of a series published as a
Sanofi Genzyme sponsored supplement. All author affiliations, conflicts of
interest statements, and acknowledgements are available in the introduction
of this issue (Gooderham JG, Hong C, Albrecht L et al. Approach to the
assessment and management of adult patients with atopic dermatitis: a
consensus document. J Cutan Med Surg. 2018;22(supple 1):3-4.).
Corresponding Author:
Chih-ho Hong, Dr. Chih-ho Hong Medical, Inc, 20-15300 105 Avenue,
Surrey, BC V3R 6A7, Canada.
Email: chihho@mail.ubc.ca
Approach to the Assessment and
Management of Adult Patients With
Atopic Dermatitis: A Consensus
Document.
Section III: Evaluation of Atopic
Dermatitis Patients for Comorbidities
Chih-ho Hong, Gordon Sussman, Irina Turchin,
Marni Wiseman, and Melinda J. Gooderham
Abstract
Atopic dermatitis (AD) is often associated with other atopic diseases, including asthma, allergic rhinitis, atopy-associated
eye disorders, and eosinophilic esophagitis. Depression and anxiety are also comorbidities to AD that significantly affect
quality of life and should be screened for in patients with AD. Links to other comorbidities such as cardiovascular disease
and malignancy are considered inconclusive, but patient counselling and screening may be appropriate in some patients. This
article highlights practical recommendations for the recognition and management of atopic and nonatopic comorbidities
commonly associated with AD.
Keywords
atopic dermatitis, comorbidities, prevalence, ocular comorbidities, depression, anxiety