Abstract
The Global Burden of Disease (GBD) Study provides an annually updated resource to study disease-related morbidity and mortality worldwide. Here we present the burden estimates for atopic dermatitis (AD), including data from inception of the GBD project in 1990 until 2017. Data on the burden of AD were obtained from the GBD Study. 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. 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.
Highlights
IntroductionAtopic dermatitis (AD) is a chronic, relapsing inflammatory skin condition affecting around20% of children[1,2] and up to 10% of adults in high income countries.[3,4,5,6] The pathogenesis is complex involving genetic susceptibility, impaired skin barrier function, dysfunctional cell-mediated immunity, and environmental and life-style factors.[7,8] AD is associated with sleep disruption, mainly due to pruritus, decreased work productivity[9] as well as depression and anxiety, which all carry additional health and economic burden for patients and their families.[10]Assessing the economic burden of AD is complex as it consists of costs for medical care, nonmedical care and indirect costs (e.g. loss of education and workdays)
We report the burden of Atopic dermatitis (AD) by prevalence rates and disability-adjusted life years (DALYs)
Out of 359 diseases and injuries analyzed by the Global Burden of Disease (GBD) 2017, AD was responsible for 0.36% of the total DALYs
Summary
Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin condition affecting around20% of children[1,2] and up to 10% of adults in high income countries.[3,4,5,6] The pathogenesis is complex involving genetic susceptibility, impaired skin barrier function, dysfunctional cell-mediated immunity, and environmental and life-style factors.[7,8] AD is associated with sleep disruption, mainly due to pruritus, decreased work productivity[9] as well as depression and anxiety, which all carry additional health and economic burden for patients and their families.[10]Assessing the economic burden of AD is complex as it consists of costs for medical care, nonmedical care and indirect costs (e.g. loss of education and workdays). 20% of children[1,2] and up to 10% of adults in high income countries.[3,4,5,6] The pathogenesis is complex involving genetic susceptibility, impaired skin barrier function, dysfunctional cell-mediated immunity, and environmental and life-style factors.[7,8] AD is associated with sleep disruption, mainly due to pruritus, decreased work productivity[9] as well as depression and anxiety, which all carry additional health and economic burden for patients and their families.[10]. The degree to which medical costs are an individual (out-of-pocket) burden or a collective one, depends largely on the health care system. This diversity is reflected in the studies on this subject. Cost increases with disease severity.[12,14,16]
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