Abstract
Adult atopic dermatitis (adult AD) is a systemic inflammatory disorder, whose relationship with immune-allergic and metabolic comorbidities is not well established yet. Moreover, treatment of mild-to-moderate and severe atopic dermatitis needs standardization among clinicians. The aim of this study was to evaluate the distribution of comorbidities, including metabolic abnormalities, rhinitis, conjunctivitis, asthma, alopecia and sleep disturbance, according to severity of adult AD, and describe treatments most commonly used by Italian dermatologists. Retrospective, observational, nationwide study of adult patients over a 2-year period was performed. Clinical and laboratory data were obtained through review of medical records of patients aged ≥ 18 years, followed in 23 Italian National reference centres for atopic dermatitis between September 2016 and September 2018. The main measurements evaluated were disease severity, atopic and metabolic comorbidities, treatment type and duration. Six-hundred and eighty-four adult patients with AD were included into the study. Atopic, but not metabolic conditions, except for hypertension, were significantly associated with having moderate-to-severe AD in young adult patients. Disease duration was significantly associated with disease severity. Oral corticosteroids and cyclosporine were the most widely used immunosuppressant. Our study seems confirm the close relationship between adult AD and other atopic conditions, further long-term cohort studies on patients affected by adult AD need to be performed to evaluate the complex relationship between adult AD disease severity and metabolic comorbidities.
Highlights
Atopic dermatitis (AD) usually appears in early childhood (15–30%) and generally resolves prior to puberty
A total of 684 adult patients with AD were included in this study, among which 79 (11.5%) were classified to have mild, 71 (10.5%) moderate, and 534 (78%) severe AD
Patients having severe diseases were significantly older than the other (p = 0.05), and no difference in adult AD severity according to sex between groups was evident (p = 0.212)
Summary
Atopic dermatitis (AD) usually appears in early childhood (15–30%) and generally resolves prior to puberty. In up to half of patients, it may persist into adulthood, becoming a lifelong condition [1, 2]. Prevalence of adult atopic dermatitis (adult AD) remains unclear, several studies have indicated that it has been increasing in recent decades, in industrialized countries [3]. Current estimates place the prevalence of AD at around 2–8% in adults, compared with 10–20% in children [4, 5]. Extended author information available on the last page of the article
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