Persistence of atopic dermatitis (AD)

A systematic review and meta-analysis

Jooho P. Kim, Lucy X. Chao, Eric Simpson, Jonathan I. Silverberg

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

Background Previous studies found conflicting results about whether childhood atopic dermatitis (AD) persists into adulthood. Objective We sought to determine persistence rates and clinical factors associated with prolonged AD. Methods A systematic review was performed in MEDLINE, EMBASE, Scopus, GREAT, LILACS, Web of Science, Academic Search Complete, and Cochrane Library. Meta-analysis was performed using Kaplan-Meier plots and random-effects proportional hazards regression. Results In total, 45 studies including 110,651 subjects spanning 434,992 patient-years from 15 countries were included. In pooled analysis, 80% of childhood AD did not persist by 8 years and less than 5% persisted by 20 years after diagnosis (mean ± SE: 6.1 ± 0.02 years). Children with AD that persisted already for more than 10 years (8.3 ± 0.08 years) had longer persistence than those with 3 (3.2 ± 0.02 years) or 5 (6.8 ± 0.06 years) years of persistence. Children who developed AD by age 2 years had less persistent disease (P < .0001). Persistence was greater in studies using patient-/caregiver-assessed versus physician-assessed outcomes, female versus male patients (P ≤ .0006), but not in those with sensitivity to allergens (P = .90). Three studies found prolonged persistence with more severe AD. Limitations Some studies did not capture recurrences later in life. Conclusions Most childhood AD remitted by adulthood. However, children with already persistent disease, later onset, and/or more severe disease have increased persistence.

Original languageEnglish (US)
Pages (from-to)681-687.e11
JournalJournal of the American Academy of Dermatology
Volume75
Issue number4
DOIs
StatePublished - Oct 1 2016

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Atopic Dermatitis
Meta-Analysis
MEDLINE
Allergens
Caregivers
Libraries
Physicians
Recurrence

Keywords

  • atopic dermatitis
  • eczema
  • epidemiology
  • persistence
  • prognosis

ASJC Scopus subject areas

  • Dermatology

Cite this

Persistence of atopic dermatitis (AD) : A systematic review and meta-analysis. / Kim, Jooho P.; Chao, Lucy X.; Simpson, Eric; Silverberg, Jonathan I.

In: Journal of the American Academy of Dermatology, Vol. 75, No. 4, 01.10.2016, p. 681-687.e11.

Research output: Contribution to journalArticle

Kim, Jooho P. ; Chao, Lucy X. ; Simpson, Eric ; Silverberg, Jonathan I. / Persistence of atopic dermatitis (AD) : A systematic review and meta-analysis. In: Journal of the American Academy of Dermatology. 2016 ; Vol. 75, No. 4. pp. 681-687.e11.
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