Adult-Onset Atopic Dermatitis

Hanifin, Jon M.

doi:10.1016/j.det.2017.02.009

Cited by 16 publications

(19 citation statements)

References 16 publications

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“…6,20 However, diagnosis does not necessarily equate with onset, and the time of AD onset remains unknown. Adult-onset AD has been suggested to represent, at least in some cases, individuals who may have forgotten their childhood disease, 23 most likely a result of recall bias, as participants with more severe childhood AD may remember their disease better than those with less severe childhood AD. Despite the uncertainty regarding onset, the proportion of participants who reported being diagnosed <2 years old increased with severity, providing support for the concept that earlier onset may be associated with persistent and more severe disease in adulthood.…”

Section: Discussionmentioning

confidence: 99%

The patient‐reported disease burden in adults with atopic dermatitis: a cross‐sectional study in Europe and Canada

Bruin‐Weller

Gadkari

Auziere³

et al. 2020

Acad Dermatol Venereol

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Background Cross-sectional data on patient burden in adults with atopic dermatitis (AD) from real-world clinical practice are limited.Objective This study compared patient-reported burden associated with adult AD across severity levels from clinical practices in Canada and Europe.Methods This study included adults (18-65 years) diagnosed with AD by dermatologists, general practitioners or allergists. Participants categorized as mild (n = 547; 37.3%), moderate (n = 520; 35.4%) or severe (n = 400; 27.3%) based on Investigator's Global Assessment completed a questionnaire that included pruritus and pain numerical rating scales, Patient-Oriented-Scoring of Atopic Dermatitis (PO-SCORAD) itch and sleep visual analogue scales, Dermatology LifeQuality Index (DLQI), and the Hospital Anxiety and Depression Scale (HADS). Participants were also stratified by inadequate efficacy/intolerance/contraindication to cyclosporine [Cyclo; n = 62 (4 mild, 18 moderate, 40 severe)] and any systemic immunomodulatory agent [IMM; n = 104 (13 mild, 31 moderate, 60 severe)] and compared with the severe group excluding participants identified as Cyclo/IMM. ResultsAge was similar across severity groups; the proportion of women was higher in the mild group relative to severe (61.2% vs. 50.5%; P < 0.001). Compared with moderate and mild, participants with severe AD had more comorbidities, higher itch and pain severity, worse sleep and higher levels of anxiety and depression (all P < 0.001). Mean AE SD DLQI score among participants with severe AD (16.2 AE 6.9) showed a large effect on quality of life that was higher than those with moderate (10.2 AE 6.3) and mild (5.5 AE 4.9) (both P < 0.001). The burden among Cyclo and IMM subgroups was generally similar to that of participants with severe AD.Conclusions Adults with AD reported a substantial burden across multiple domains that was significantly higher in those with severe disease. The burden among participants in the Cyclo/IMM subgroups was similar to those with severe AD.

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Section: Discussionmentioning

confidence: 99%

The patient‐reported disease burden in adults with atopic dermatitis: a cross‐sectional study in Europe and Canada

Bruin‐Weller

Gadkari

Auziere³

et al. 2020

Acad Dermatol Venereol

View full text Add to dashboard Cite

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“…In stratified analyses, the effect estimates for hypertension, MI and stroke were null among those who reported AD onset in childhood and were negative among those who reported AD onset in adulthood. The reasons for the differences across strata are unclear and there is controversy as to whether adult‐onset AD is a distinct entity from childhood‐onset AD; some postulate that reports of adult onset are simply forgotten childhood‐onset cases . Reported childhood‐onset AD may have resolved in childhood with annulment of any impact (positive or negative) on cardiovascular risk later in life.…”

Section: Discussionmentioning

confidence: 99%

Atopic dermatitis and risk of hypertension, type 2 diabetes, myocardial infarction and stroke in a cross-sectional analysis from the Canadian Partnership for Tomorrow Project

et al. 2017

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“…Similar to other survey‐based assessments, many participants report onset of AD in adulthood. It has been questioned whether AD can truly have its first onset in adulthood; perhaps these are cases who had mild or transient disease in early childhood that have since been forgotten . Factors associated with forgetting a previous diagnosis of AD include earlier AD onset, less disabling disease, transient disease and a lack of other atopic conditions .…”

Section: Discussionmentioning

confidence: 99%

“…It has been questioned whether AD can truly have its first onset in adulthood; perhaps these are cases who had mild or transient disease in early childhood that have since been forgotten. 25 Factors associated with forgetting a previous diagnosis of AD include earlier AD onset, less disabling disease, transient disease and a lack of other atopic conditions. 26,27 As such, NHS2 questionnaires administered during adulthood likely fail to capture resolved cases of mild, transient childhood AD.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis validation and clinical characterization of atopic dermatitis in Nurses’ Health Study 2

Drucker

Cho

et al. 2019

Acad Dermatol Venereol

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Background Epidemiologic studies of atopic dermatitis (AD) are often limited by case definitions that have not been validated. Objective In this study, we assessed the accuracy of self‐report of AD in a large cohort of US female nurses, the Nurses’ Health Study 2 (NHS2). We also provide clinical characteristics of AD in the cohort. Methods We sent an electronic questionnaire to NHS2 participants who previously reported ever having a diagnosis of AD. This questionnaire was designed to confirm cases of AD using previously validated algorithms with >85% specificity. We assessed the association of AD with asthma, comparing the results when different definitions of AD were applied. We also inquired about various aspects of participants’ AD. Results Responses were received from 2509 of 5126 (49%) nurses who were sent the questionnaire, with an average age of 62. Most participants (1996/2509, 80%) reiterated their previously reported clinician diagnosis of AD. Application of the two diagnostic algorithms yielded confirmation of 1538 and 1293 prevalent cases, respectively. The association of AD with asthma was stronger when more stringent AD case definitions were applied. Participants generally reported mild disease (92% with ≤10% maximal body surface area involved) and a high proportion (57%) reported adult‐onset disease. Conclusions Self‐report of AD diagnosis has good reliability, and future analyses will be strengthened by our ability to conduct sensitivity analyses with refined confirmed AD subgroups.

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Adult-Onset Atopic Dermatitis

Cited by 16 publications

References 16 publications

The patient‐reported disease burden in adults with atopic dermatitis: a cross‐sectional study in Europe and Canada

The patient‐reported disease burden in adults with atopic dermatitis: a cross‐sectional study in Europe and Canada

Atopic dermatitis and risk of hypertension, type 2 diabetes, myocardial infarction and stroke in a cross-sectional analysis from the Canadian Partnership for Tomorrow Project

Diagnosis validation and clinical characterization of atopic dermatitis in Nurses’ Health Study 2

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