Treatment of Childhood Atopic Dermatitis and Economic Burden of Illness in Asia Pacific Countries

Abstract

Atopic dermatitis (AD) is a common chronic inflammatory skin condition in children. In Asia, the prevalence of AD is increasing, which is largely attributed to environmental and socioeconomic factors including family income, parental education, lifestyle and metropolitan living. Current clinical guidelines recommend a stepped approach in the management of eczema in children, with treatment steps tailored to the severity of the eczema. To address the skin barrier dysfunction, skin hydration and the application of emollients is essential. There is evidence supporting the use of bleach baths as an antimicrobial therapy against Staphylococcus aureus. In patients in whom topical treatment fails, wet wrap therapy may be considered as a treatment option before considering systemic therapies. In the second part of this article, the economic burden of AD is addressed. AD not only negatively impacts the child's quality of life but also that of the whole family and is associated with a burden on health-care costs and society. AD in an infant will lead to frequent additional visits to the pediatrician, to additional and partially expensive treatment costs and, in rare cases, to hospitalization. It is thus of utmost importance to define efficient strategies to not only treat AD but also to decrease the risk of developing the disease.

Burden of atopic dermatitis in Asia

“…Because AD often affects children younger than 12 years, it also has a significant impact on family quality of life (QoL) because of factors such as sleep deprivation, financial costs and lifestyle changes . The economic costs associated with AD are significant, encompassing direct costs, such as medical visits and treatment costs, and indirect costs, including decreased productivity and time lost from work …”

“…With an estimated global prevalence of nearly 230 million, AD is considered one of the most common chronic conditions . The prevalence of AD is also increasing in much of the world, including large parts of Asia . For example, in Taiwan, the lifetime prevalence of AD in patients aged 12–15 years increased from 2.4% to 4.0% between 1996 and 2001, per an International Study of Asthma and Allergies in Childhood (ISAAC)‐based report .…”

“…Comparable increases in lifetime prevalence of AD in similarly aged patients have also been observed in China (aged 13–14 years), Japan (aged 7–15 years) and South Korea (aged 12–15 years) . This is most often attributed to changing socioeconomic and environmental factors, including rapid urbanization, adoption of a Westernized lifestyle, and improved standards of living and education . Although the burden of AD in Western cultures has been reviewed extensively, information is limited regarding the impact of AD in the wider Asia region.…”

Breastfeeding duration modifies the effect of smoking during pregnancy on eczema from early childhood to adolescence

“…Characteristically, an early onset eczema often progresses to other allergic diseases [6–9], a phenomenon known as atopic march [8, 9]. In addition to a low quality of life [4, 10] of the affected individual, it also poses an economic burden on the families due to high cost of treatment [10, 11]. …”

Editorial

“…In the second article, Bee Wah Lee and Patrick R. Detzel [8] examine the management and cost burden of childhood atopic dermatitis in the Asia Pacific region. The treatment practices in this region are not only influenced by the different health-care systems, but also by cultural and environmental factors, such as climate and access to medical care.…”