Atopic dermatitis among children and adolescents in the Arctic region – a systematic review and meta‐analysis

Abstract

The prevalence of atopic dermatitis (AD) varies across the globe, and the clinical phenotype with racial background and ethnicity. AD in the Arctic region has only been scarcely studied. We performed a systematic review and meta-analysis to examine the prevalence, clinical manifestations and risk factors for AD among children and adolescents in the Arctic.Three medical databases PubMed, Embase and Web of Science were screened. All studies published between 1990 to 2020 with epidemiologic data on AD in children and adolescents in the Arctic region, were included. Data were extracted and a meta-analysis was performed to obtain pooled proportions and incidences with 95% confidence intervals (CI). We identified 21 studies from 8 different Arctic regions with 31 403 participants. The cumulative incidence of AD was 23% (95% CI 20-26) and 1-year prevalence was 19% (95% CI 15-25). The incidence of AD was higher in the Arctic parts of Scandinavia and lower in Greenland and Russia. Children of indigenous descent had a slightly lower incidence of AD (19%, 95% CI 13-26) compared to the overall population. The dominant phenotype of AD was mild to moderate flexural dermatitis with facial involvement. Asthma and allergic rhinitis were common and observed in 20-30% of children with AD. In conclusion, AD is highly prevalent in the Arctic, but varies between regions and races. Indigenous children living in less urbanized countries appear to have a slightly lower risk of AD. Future studies should confirm this and examine whether this correlation relates to behavioural differences or genetic signature.

Ethnic endotypes in paediatric atopic dermatitis depend on immunotype, lipid composition and microbiota of the skin

“…12,41 This may also be associated to environmental changes following urbanization, further supported an increased atopic diseases including AD among children and adults in Greenland during the same period. [41][42][43] Danish AD children seemed to have a compensatory increased CER production in lesional skin leading to shorter chain lengths. This might in part be related to the increased S. aureus colonization in Danish AD skin.…”

“…Inuit children had high levels of epidermal IL‐5, a cytokine typically involved in eosinophil recruitment and differentiation, which could indicate a more allergic endotype, further supported by high a prevalence of asthma and allergic rhinitis in Inuit children 12,41 . This may also be associated to environmental changes following urbanization, further supported an increased atopic diseases including AD among children and adults in Greenland during the same period 41–43 …”

Patterns in contacts with primary health care centres in Greenland

“…A previous study found that 13% of all consultations in PHC in Greenland was related to problems with the skin [ 2 ]. Furthermore, a meta-analysis of atopic dermatitis (AD) among children and adolescents in the Arctic region, found AD to be highly prevalent [ 16 ].…”

Genetic support for the causal association between 91 circulating inflammatory proteins and atopic dermatitis: A two‐sample Mendelian randomization trial

“…Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by eczema‐like changes in the skin related to genetic allergic factors, and it is one of the most common inflammatory skin diseases. 1 Epidemiological surveys have shown that the incidence of AD in children can reach 20%, 2 and the average prevalence in adults is approximately 4.9%. 3 The clinical manifestations of this disease are diverse, and its basic characteristics include dry skin, chronic eczematoid skin lesions, and obvious itching, which have a serious impact on the quality of life of patients and increase the burden of medical care on society.…”