Summary Background The Global Burden of Disease (GBD) Study provides an annually updated resource to study disease‐related morbidity and mortality worldwide. Objectives Here we present the burden estimates for atopic dermatitis (AD), including data from inception of the GBD project in 1990 until 2017. Methods Data on the burden of AD were obtained from the GBD Study. Results Atopic dermatitis (AD) ranks 15th among all nonfatal diseases and has the highest disease burden among skin diseases as measured by disability‐adjusted life‐years (DALYs). Overall, the global DALY rate for AD in 1990 was 121 [95% uncertainty interval (UI) 65·4–201] and remained similar in 2017 at 123 (95% UI 66·8–205). The three countries with the highest DALY rates of AD were Sweden (327, 95% UI 178–547), the UK (284, 95% UI 155–478) and Iceland (277, 95% UI 149–465), whereas Uzbekistan (85·1, 95% UI 45·2–144), Armenia (85·1, 95% UI 45·8–143) and Tajikistan (85·1, 95% UI 46·1–143) ranked lowest. Conclusions The global prevalence rate of AD has remained stable from 1990 to 2017. However, the distribution of AD by age groups shows a bimodal curve with the highest peak in early childhood, decreasing in prevalence among young adults, and a second peak in middle‐aged and older populations. We also found a moderate positive correlation between a country’s gross domestic product and disease burden. GBD data confirm the substantial worldwide burden of AD, which has remained stable since 1990 but shows significant geographical variation. Lifestyle factors, partially linked to affluence, are likely important disease drivers. However, the GBD methodology needs to be developed further to incorporate environmental risk factors, such as ultraviolet exposure, to understand better the geographical and age‐related variations in disease burden.
We live in an era of edited selfies and ever-evolving standards of beauty. The advent and popularity of image-based social media have put Photoshop and filters in everyone's arsenal. A few swipes on Snapchat can give your selfie a crown of flowers or puppy ears. A little adjusting on Facetune can smoothen out skin, and make teeth look whiter and eyes and lips bigger. A quick share on Instagram, and the likes and comments start rolling in. These filters and edits have become the norm, altering people's perception of beauty worldwide.Earlier, photo-editing technology was widely available only for celebrities. Models and actors were made to look perfect in magazines and ads, but the general public did not have easy access to methods to alter their own appearance. They instead were left to idolize the standard of beauty present in the media, although most were aware of the editing and alterations that went into making celebrities look flawless. 1 Today, with apps like Snapchat and Facetune, that same level of perfection is accessible to everyone. Now, it is not just celebrities propagating beauty standards: it is a classmate, a coworker, or a friend. The pervasiveness of these filtered images can take a toll on one's self esteem, make one feel inadequate for not looking a certain way in the real world, and may even act as a trigger and lead to body dysmorphic disorder (BDD).Body dysmorphic disorder is an excessive preoccupation with a perceived flaw in appearance, classified on the obsessive-compulsive spectrum. 2 The disorder is more than an insecurity or a lack of confidence. Those with BDD often go to great lengths to hide their imperfections, engage in repetitive behaviors like skin picking or grooming, and may visit dermatologists or plastic surgeons frequently, hoping to change their appearance. A recent study 3 analyzed the effect of edited selfies on body dissatisfaction among adolescent girls and found that those who manipulated their photos more reported a higher level of concern with their bodies and an overestimation of body shape and weight. The study also suggested that those with a dysmorphic body image may seek out social media as a means of validating their attractiveness. Finally, those with a higher level of engagement on social media-including those actively trying to present a specific image of oneself or analyzing and commenting on other's photos-may have a higher level of body dissatisfaction. 3 The desire for cosmetic surgery is an important component of BDD. It is known that the angle and close distance at which selfies are taken may distort facial dimensions and lead to dissatisfaction. 4 Patients VIEWPOINT
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