Prevalence Of Atopic Dermatitis Research Articles

ATOPIC DERMATITIS: IMPROVING EARLY DETECTION AND PREVENTION MEASURES IN THE COMMUNITY SETTING

Atopic dermatitis is a chronic inflammation of the skin characterized by disruption of the skin barrier and aberrations in the immune response. In general, atopic dermatitis can be affected by various complex interactions including genetics, diet, and stress. The lack of public attention to atopic dermatitis which often affects children is one of the factors for the increasing prevalence of atopic dermatitis. The purpose of this community service is to help the community understand the importance of early detection and allergy prevention efforts. Community service is carried out by holding online seminars that can be followed by the general public as well as direct consultations and discussions with pediatricians for allergy patients at the Department of Pediatrics at Dr. RSUD Dr. Saiful Anwar Malang. The total Immunoglobulin E level of the respondents was measured using the enzyme-linked immunosorbent assay method. The severity of the respondents was determined by calculating the SCORAD index. The results of early detection showed that 100% of respondents had intrinsic atopic dermatitis, 90% with mild severity and 10% with moderate severity. After being checked for allergies, the respondents received the appropriate supplements. Conclusion: By holding this community service activity, ordinary people become more aware of the importance of treating allergic diseases as early as possible because the incidence of atopic dermatitis can be reduced and the quality of life of patients can be improved. This outreach activity must be carried out continuously in the following years.

Prevalence of Allergy Symptoms in Schoolchildren of Chechen Republic (ISAAC Questionnaire Results)

Background. Rising prevalence of allergic diseases is a major medical and social problem.Objective. The aim of the study is to study the prevalence of allergy symptoms in schoolchildren of Chechen Republic according to the ISAAC (International Study of Asthma and Allergy in Childhood) questionnaire.Methods. We have surveyed 3,398 schoolchildren from 26 randomly chosen schools located in 2 urban and 2 rural areas of Chechen Republic. The first age group (7–8 years old) included 1331 first graders, the second group (13-14 years old) — 2067 eighth graders.Results. The prevalence of allergic diseases symptoms according to the questionnaire was the following: bronchial asthma (BA) — 18.4% (625 children), allergic rhinitis (AR) — 16.6% (565 children), atopic dermatitis (AD) — 4.7% (160 children), while medically verified diagnosis was established in dramatically less cases. Analysis of BA, AR, AD symptoms prevalence has revealed significant correlation between studied parameters and age. Symptoms of BA, AR prevailed in the older age group, AD in the younger one. There were no gender differences identified. Higher prevalence of BA and AR symptoms was recorded in urban residents, while the prevalence of AD in urban and rural areas was quite the same. Moreover, estimation of allergy symptoms prevalence revealed mild course of these diseases in schoolchildren of Chechen Republic.Conclusion. The study, conducted with ISAAC questionnaire, demonstrates high prevalence of allergy symptoms in schoolchildren of Chechen Republic, exceeding the official statistics. It requires particular attention from the healthcare system and improved diagnostic methods for allergies.

Deacetylasperulosidic Acid Ameliorates Pruritus, Immune Imbalance, and Skin Barrier Dysfunction in 2,4-Dinitrochlorobenzene-Induced Atopic Dermatitis NC/Nga Mice.

The prevalence of atopic dermatitis (AD), a disease characterized by severe pruritus, immune imbalance, and skin barrier dysfunction, is rapidly increasing worldwide. Deacetylasperulosidic acid (DAA) has anti-atopic activity in the three main cell types associated with AD: keratinocytes, mast cells, and eosinophils. Our study investigated the anti-atopic activity of DAA in 2,4-dinitrochlorobenzene-induced NC/Nga mice. DAA alleviated the symptoms of AD, including infiltration of inflammatory cells (mast cells and eosinophils), epidermal thickness, ear thickness, and scratching behavior. Furthermore, DAA reduced serum IgE, histamine, and IgG1/IgG2a ratio and modulated the levels of AD-related cytokines and chemokines, namely interleukin (IL)-1β, IL-4, IL-6, IL-9, IL-10, IL-12, tumor necrosis factor-α, interferon-γ, thymic stromal lymphopoietin, thymus and activation-regulated chemokine, macrophage-derived chemokine, and regulated on activation the normal T cell expressed and secreted in the serum. DAA restored immune balance by regulating gene expression and secretion of Th1-, Th2-, Th9-, Th17-, and Th22-mediated inflammatory factors in the dorsal skin and splenocytes and restored skin barrier function by increasing the expression of the pro-filaggrin gene and barrier-related proteins filaggrin, involucrin, and loricrin. These results suggest DAA as a potential therapeutic agent that can alleviate the symptoms of AD by reducing pruritus, modulating immune imbalance, and restoring skin barrier function.

Allergic march in children of Ukraine

Allergic diseases, which have a certain stage in their development from food allergy to bronchial asthma / allergic rhinitis, are much more common in children than in adults. The aim of this study was to analyze data on the prevalence and incidence of atopic dermatitis, bronchial asthma and allergic rhinitis as components of the allergic march, in children of Ukraine from 1994 to 2017 to determine the possible impact of adverse environmental factors on their development. During the same period, due to the influence of a number of factors, in particular environmental, there were significant changes in the structure of allergic diseases making up the stages of the allergic march due to an increase in the proportion of allergic rhinitis with the reduced one of asthma and atopic dermatitis. Within 24 years, the incidence of atopic dermatitis in children aged 0-6 years including, increased by 27.6%, in adolescents - by 40.5% and significantly decreased by 39.5% in children aged 7-14 years including. Most cases of allergic rhinitis and bronchial asthma were observed in schoolchildren (47.6 and 54.0%, respectively) with a slight decrease compared to 1994. In general, allergic diseases in recent years have become more common in children from 0 to 6 years and their detection has decreased in school-age children and adolescents. Over the past 24 years, in children of Ukraine a steady increase in the incidence and prevalence of allergic diseases that form an allergic march has been noted: the prevalence of bronchial asthma has increased by 69.3% and the incidence has increased by 22.9%; the prevalence of atopic dermatitis increased by 43.9% and the incidence increased by 8.3%; the prevalence of allergic rhinitis increased by 488.3% and the incidence of allergic rhinitis increased by 380.3%, with a predominance of detection of this pathology in children from regions with developed infrastructure and industry, where there are significant emissions of pollutants into the atmosphere, that have a direct moderate effect on the increase in the prevalence of bronchial asthma, the incidence and prevalence of allergic rhinitis in children.

Caesarean Delivery and the Risk of Atopic Dermatitis in Children

To investigate whether cesarean delivery increases a child’s risk of atopic dermatitis (AD) by the age of 4 by using data from a large integrated health care delivery system. It has been hypothesized that cesarean delivery may disrupt maternal–infant microbial transfer, thereby affecting immune system development and increasing the risk of atopic dermatitis in children.Mothers who had a singleton live birth at a Kaiser Permanente North California or contracting hospital between January 1, 2005, to January 1, 2014 and whose child had continuous enrollment in the Kaiser Permanente North California system for at least 4 years were included in the study (n = 173 105). Among this birth cohort, a subsample of births (n = 102 327) occurring mostly after 2008 because of the adoption of electronic health records included more detailed information of cesarean delivery conditions (start of labor, timing of membrane rupture, and cesarean delivery indication).In this observational study, the researchers collected maternal and child information using these data sources: electronic health record, pharmacy databases, state birth records, and a prospectively collected survey regarding breastfeeding behavior at 2 months of age. The authors used modified Poisson regression models with robust variance estimation to assess the association between cesarean delivery and atopic dermatitis overall and when stratified by demographic and labor and delivery characteristics.There were 173 105 children born to 135 102 mothers during the study time period. A total of 12% of the children (n = 20 819) met the case definition for AD, and 26.6% of the births were born via cesarean delivery. The prevalence of AD was higher among children who were male, born term, were first born and did not have an NICU admission. Mothers of children with AD were more likely to be people of color (African-American, Asian, or Pacific Islander) and have underweight prepregnancy BMI. The prevalence of cesarean delivery was higher among mothers who were older, had higher levels of education, had a higher prepregnancy BMI, and were African American race. Infants born by cesarean delivery were more likely to be born at an earlier gestational age, had a high or low birth weight, were in the NICU, and were first born. In the primary multivariate model controlling for all covariates, there was little evidence that children born via cesarean delivery were more likely to develop AD by age 4, compared with children born vaginally (risk ratio [RR]: 1.02; confidence interval [CI]: 0.99 to 1.05). Among all stratified models (AD diagnosis before or after 6 months, maternal atopy, gestational age, birth order, prepregnancy BMI, and child’s sex), the RR for cesarean delivery and AD was minimal. Cesarean delivery conditions indicative of the least exposure to maternal microbiome (ie, no labor and short interval between membrane rupture and delivery) revealed no evidence of association with AD. In addition, intrapartum antibiotics, breastfeeding, or familial factors did not strongly influence an association. Only term infants born via cesarean delivery because of a breech or other malpresentation with labor (RR: 1.07; CI 0.94 to 1.21) or because of failure to progress (RR: 1.09; CI: 1.01 to 1.17) showed modest evidence of higher risk of AD by the age of 4 years, compared with term infants born vaginally.Delivery by cesarean delivery was not associated with an increased risk of atopic dermatitis by the age of 4 years.The authors point out that this is the largest study-to-date using observational data for a US-based birth cohort regarding mode of delivery and atopic dermatitis development. The results of this study are consistent with previous research findings. The strengths of this study are the large amount of data analyzed and the prospectively collected information on cesarean delivery conditions, intrapartum antibiotic administration, breastfeeding information, and within-family characteristics (via a matched sibling analysis).

Autism spectrum disorders and atopic dermatitis: a new perspective from country-based prevalence data

Recently, a continuous growth for both neurodevelopmental and atopic diseases’ incidence was seen throughout the world. Notably, autism spectrum disorders (ASD) and atopic dermatitis (AD) attracted the attention of clinicians and scientists for their impact on the quality of life of patients, starting during childhood. Despite a number of hypotheses about common pathogenesis between the two disorders, uncertainty is still present, and data coming from various parts of the world are contradictory. Fortunately, works recently published have brought useful material for comparative analysis to the benefit of the scientific community, making large scale, country-based perspectives methodologically viable. In light of that, the present study took into account uniform data, available from country-based registries or related publications, dealing with the prevalence of the two conditions around the world, and tried to setup a simple correlation analysis between the two. According to such data, the growth of AD and ASD prevalence appear uncorrelated, leading to hypothesise that, if a common etiopathological pathway exists between the two conditions, they are likely to interact to each other due to a complex interplay of co-morbidities, genes and environmental players not enough explained by a simple correlation analysis. Such facts are worth investigation in future research.

Prevalence of atopic dermatitis in adults

Prevalence of atopic dermatitis in adults

Comorbidities and Environmental Factors Associated with Atopic Dermatitis in Children and Adults in Dermatology-Venereology in Cotonou, Benin.

Introduction The objective of this work was to document the comorbidities and environmental factors associated with atopic dermatitis (AD) in dermatology Venereology in Cotonou. Methods A cross-sectional, prospective, and analytical study included, from January 2016 to December 2018, in the Dermatology-Venereology Department of the National Teaching Hospital Hubert Koutoukou Maga (CNHU-HKM) of Cotonou, children and adults after free and informed consent, in whom the diagnosis of AD was retained according to the criteria of the United Kingdom Working Party. Severity was assessed using SCORAD (severity scoring of atopic dermatitis). Results The overall prevalence of AD was 7.7%. AD was more frequent in children (56.8% and 40.6%) and adults (59.8% and 37.4%) from urban and periurban areas (0.003 < p < 0.034). It was more frequent in children who regularly dewormed and those with complete vaccination (0.001 < p < 0.01). In 54.8% of children and 58.9% of adults, flare-ups occurred during the warm season. The main associated comorbidities were rhinitis and conjunctivitis in both children (49.7% and 36.1%, respectively) and adults (32.7% and 26.2%, respectively). The main triggering factors in children were heat (43.2%), pneumallergens (28.4%), and skin irritants (22.6%). In adults, we noted skin irritants (58.9%), heat (47.7%), and psychological factors (34.6%). In adults, the use of detergent soaps was associated with lichenified and severe AD (0.003 < p < 0.006) and that of lightening soaps with acute AD (p=0.042). Conclusion AD in the Dermatology-Venereology Department of the CNHU-HKM of Cotonou was associated with comorbidities. It was influenced by environmental factors related to the tropical climate and by skin irritants or allergens.

Sensitivity of clinician-assessed efficacy outcome measurement instruments in trials of topical therapies for atopic dermatitis: a systematic review and meta-analysis.

The rising prevalence of atopic dermatitis (AD) in developing countries and its substantial socioeconomic impact have furthered research over the last two decades giving way to advances in its aetiopathogenesis and treatment. Topical therapies targeting newly identified AD signalling pathways are being developed. Numerous clinician-assessed disease severity outcome measurement instruments (OMIs) are available to evaluate the efficacy of investigational treatments in proof-of-concept (POC) trials for AD. However, little is known about the comparative sensitivity of these efficacy OMIs. We performed a systematic review and meta-analysis to compare the sensitivity of different OMIs in controlled trials of topical therapies for AD published between January 1, 2000 and April 7, 2020. Treatment effect size of OMIs reported at Week 4 was calculated with 95% Confidence Interval (CI). The sensitivity of OMIs was compared by pooling the standardized difference between means (Cohen's d and Cohen's h) for any two OMI-parameter combinations that were reported in ≥3 studies identified in our systematic review. Assessed parameters were difference between active and vehicle at Week 4 and change from baseline [CFB] and percentage change from baseline [%CFB] at Week 4. We identified a total of 15 studies with 3313 subjects examining 14 different OMIs were included in this quantitative meta-analysis. Continuous OMIs had a significantly higher treatment effect size vs. dichotomous OMIs (P = 0.006). Comparisons of Eczema Area and Severity Index (EASI), Investigator's Global Assessment (IGA), body surface area (BSA) and SCORing Atopic Dermatitis (SCORAD) for available parameters were performed and generally had a similar sensitivity, with BSA showing smaller overall effect size estimates. In conclusion, continuous OMIs used in topical clinical trials for AD had significantly higher treatment effect sizes when compared to dichotomous OMIs. Continuous OMIs could provide more power for POC trials with a small sample size in atopic dermatitis with topical therapies.

Клинические и иммуногенетические особенности течения атопического дерматита

Актуальность. Атопическим дерматитом (АД) страдает 10-20% педиатрического и 1-3% взрослого населения. Распространенность АД в течение последних 30 лет выросла во всем мире, включая около пятой части населения развитых стран. Атопический дерматит или атопическая экзема является хроническим воспалительным заболеванием кожи, представляет серьезную проблему общественного здоровья во всем мире. Эта болезнь имеет существенный социально-экономическое бремя частично из-за отсутствия эффективного лечения, способного контролировать болезнь в долгосрочной перспективе. Целью исследования стал анализ современных представлений патогенеза и особенностей течения атопического дерматита. Материалы и методы. В процессе исследования были использованы методы семантического оценивания научных документов, а также методы структурного и логического анализа. В исследовании использованы материалы планирования и выполнения диссертационной работы по специальности 14.01.20 - кожные и венерические болезни и 14.03.08 - иммунология и аллергология. Результаты. В статье представлены результаты анализа обзора современных научных исследований патогенеза и особенностей течения атопического дерматита. Проанализированы последние направления научного поиска, научная новизна, теоретическое и практическое значение достижений научных исследований в практическом здравоохранении. Освещены подходы к современной профилактики и лечения атопического дерматита. Выводы. Наше настоящее понимание о АД резко изменилось на протяжении последних годов, главным образом, из-за значительного прогресса в эпидемиологии и генетике, огромный прорыв в понимании концепции атопического марша, а также раскрытия новых аспектов анамнеза болезни и изучения форм АД, которые персистируют в течение всей жизни. Четкое определение различных клинических фенотипов, с одной стороны, и потенциальных биомаркеров с другой являются ключевыми элементами для успешного развития новых и персонализированных терапевтических подходов у больных АД.

Increased Prevalence of Atopic Dermatitis in Children Aged 0-3 Years Highly Exposed to Parabens.

The prevalence of allergic diseases, such as bronchial asthma, atopic dermatitis, nasal allergies (pollinosis), and food allergies, has been increasing in many countries. The hygiene hypothesis was recently considered from the perspective of exposure to antimicrobial agents and preservatives, such as parabens (CAS number, 94-13-3). It currently remains unclear whether parabens, which are included in many daily consumer products such as cosmetics, shampoos, and personal care products as preservative antimicrobial agents, induce or aggravate allergies. Therefore, the aim of the present study was to examine the relationship between exposure to parabens and the prevalence of allergic diseases in Japanese children. The cross-sectional epidemiology of 236 children aged 0–3 years who underwent health examinations in Shika town in Japan assessed individual exposure to parabens using urinary concentrations of parabens. The results obtained showed that the prevalence of atopic dermatitis was significantly higher in children with high urinary concentrations of parabens than in those with low concentrations (p < 0.001). This relationship remained significant after adjustments for confounding factors, such as age, sex, Kaup’s index, and passive smoking (p < 0.001). In conclusion, the present results from a population study suggested a relationship between atopic dermatitis and exposure to parabens. A longitudinal study using a larger sample number and a detailed examination of atopic dermatitis, including EASI scores and exposure to parabens, will be necessary.

The Influence of Atopic Dermatitis on Health-Related Quality of Life in Bangladesh.

Atopic dermatitis (AD) is the foremost non-fatal skin-related disease that affects all age groups. Despite the growing prevalence of AD in low- and middle-income countries, its physiological consequences remain overlooked in countries like Bangladesh. Therefore, we aim to assess and characterize the influence of AD on the health-related quality of life (HRQoL) in Bangladeshi patients. A cross-sectional study comprising 184 eligible adults (83 men and 101 women; mean age, 33.46 ± 15.44 years) was conducted at the dermatology outpatient department of Shaheed Suhrawardy Medical College Hospital (a tertiary hospital in Dhaka, Bangladesh). AD was determined using the UK Working Party criteria. A structured questionnaire, Eczema Area and Severity Index (EASI), and Dermatology Life Quality Index (DLQI) were administered to obtain information on patient characteristics, AD severity, and HRQoL. The mean DLQI score for the entire sample was 11.29 ± 5.27 (range, 1–26), and 51.60% reported the disease greatly affected their lives. Bivariate analysis revealed significant differences in self-rated health measures of DLQI scores in terms of self-reported AD severity, overall health, and the EASI. In multivariable regression models adjusted for patient characteristics, the self-perceived severe AD group reported significantly higher DLQI scores (coefficient = 2.72; 95% confidence interval (CI) = 0.38–5.05; p = 0.022) than the mild group. Concurrently, we observed a substantial increase in the DLQI scores among patients with moderate and severe EASI scores (coefficient = 1.96, 95% CI = 0.08–3.92, p < 0.05 and coefficient = 4.35, 95% CI = 1.98–6.72, p < 0.001, respectively) than in those with mild EASI scores, suggesting that HRQoL was markedly influenced by greater AD severity. These findings highlight the need for a more patient-centric approach to the management of AD in order to alleviate patient suffering and, thereby, improve HRQoL.

Atopic Dermatitis: Epidemiology and Clinical Phenotypes.

Atopic dermatitis (AD) is a chronic, lifelong, relapsing condition. The wide spectrum of the possible clinical presentations, depending on patient' s age, age of onset of disease, topography and morphology of dermatitis, limits the epidemiologic information on its prevalence and incidence. A clear definition of the different clinical AD phenotypes and epidemiology is essential for an appropriate patient's treatment and management, in particular for adults. This review summarizes the most recent epidemiologic data from the 21st century, on AD prevalence and incidence rates either in children or adults, with a special focus on their trends in Europe. Moreover, an effort to categorize diverse AD clinical expressions, has been made, aiming to facilitate differential diagnosis and speed up the start of the correct therapy.

Atopic dermatitis and nutrition

Atopic dermatitis, a common chronic and pruritic inflammatory skin disorder, can create significant disruptions in sleep and quality of life. Atopic dermatitis is especially common in infants and children; therefore, safe and natural therapeutic options have considerable appeal. Over the past several decades, there has been an increase in the prevalence of atopic dermatitis in industrialized nations. Also, there is variability in the prevalence of atopic dermatitis in the United States, both across and within states. Environmental factors including diet are believed to be associated with this increased risk. Dietary interventions continue to be an area of keen interest and have been studied extensively, albeit with variable results. Maternal dietary restrictions during pregnancy and lactation, hydrolyzed or partially hydrolyzed formulas, delaying the introduction of solid foods, and omega-3 or omega-6 fatty acids supplementation do not appear to have a beneficial effect on the treatment and prevention of atopic dermatitis. Exclusive breastfeeding for 3 to 4 months, a diet high in fruits and vegetables, and prebiotics might have a beneficial effect. Because environmental triggers, including dietary exposures, are thought to play a role in the pathogenesis of atopic dermatitis, we herein review the current literature on the role of dietary habits, vitamin and mineral supplementation, and probiotics on the treatment and prevention of atopic dermatitis.

Association Between Prenatal Exposure to Metals and Atopic Dermatitis Among Children Aged 4 Years in Taiwan

The prevalence of atopic dermatitis has substantially increased in recent decades, and atopic dermatitis could lead to allergic airway inflammation later in life. A previous study found that inorganic arsenic exposure was associated with allergic airway inflammation in children aged 8 to 14 years. However, the association between prenatal exposure to arsenic and other metals and the risk of atopic dermatitis among young children remains unknown. To assess the association between prenatal exposure to arsenic and other metals and the occurrence of atopic dermatitis in children at age 4 years. In total, 1152 pregnant women were enrolled in the original Taiwan Maternal and Infant Cohort Study (TMICS), a multicenter birth cohort study conducted at 9 hospitals in northern, central, southern, and eastern Taiwan from October 2012 to May 2015. Of those, 586 mothers and children aged 4 years participated in follow-up questionnaire interviews from August 2016 to January 2019. After excluding 216 participants with missing data, the final statistical analysis of follow-up data included 370 mother and child pairs from the central and eastern regions of Taiwan. Data were analyzed from February 2 to August 12, 2021. Arsenic, cadmium, lead, cobalt, copper, nickel, thallium, and zinc during pregnancy. The outcome was parent-reported atopic dermatitis history among children aged 4 years. The presence of atopic dermatitis was defined as a positive response to the question, "Has your child ever had atopic dermatitis diagnosed by a physician?" During the initial TMICS study period, concentrations of arsenic, cadmium, lead, cobalt, copper, nickel, thallium, and zinc were measured in maternal urine during the third trimester of pregnancy using an inductively coupled plasma mass spectrometer. Estimated total inorganic arsenic exposure was calculated using a model that included data on both total arsenic and arsenic species (arsenite, arsenate, monomethylarsonate, and dimethylarsenate) obtained from a previous TMICS cohort. Among 370 children included in the analysis, the mean (SD) age was 3.94 (0.59) years; 208 children (56.2%) were male, and 267 children (72.2%) were from the central region of Taiwan. A total of 110 children (29.7%) had atopic dermatitis at age 4 years. Maternal estimated total inorganic arsenic exposure during pregnancy was associated with increased odds of atopic dermatitis among children at age 4 years (odds ratio [OR], 2.42 [95% CI, 1.33-4.39] for every doubled increase of total inorganic arsenic) after adjusting for parental allergies, child's sex, geographic area, maternal educational level, and exposure to tobacco smoke. Every increased unit in the weighted quantile sum index of maternal metal exposure was significantly associated with atopic dermatitis (OR, 1.63; 95% CI, 1.28-2.07). Arsenic (40.1%) and cadmium (20.5%) accounted for most of the metal mixture index. This cohort study found that prenatal exposure to inorganic arsenic and coexposure to inorganic arsenic and cadmium were associated with a higher risk of atopic dermatitis in young children. These findings suggest that prevention of exposure to inorganic arsenic and cadmium during pregnancy may be helpful for the control of atopic dermatitis and other potential allergies in children.

Salvianolic Acid A Suppresses DNCB-Induced Atopic Dermatitis-Like Symptoms in BALB/c Mice.

Prevalence of atopic dermatitis (AD), a chronic, pruritic, and relapsing inflammatory skin disorder, is growing. Because available therapeutics is limited, immune regulators from natural resources could be helpful for treating AD symptoms. The root of Salvia miltiorrhiza Bunge (Lamiaceae) has been studied for the treatment of inflammatory diseases, including dermatologic disorders in Korea. This study examined the effect of salvianolic acid A on AD-like symptoms. Sensitization on the dorsal skin and repeated application on the ears with 2,4-dinitrochlorobenzene (DNCB) were performed in BALB/c mice to induce AD-like skin lesions. After induction of atopic dermatitis, salvianolic acid A (5 and 10 mg/kg) or dexamethasone (10 mg/kg) were administrated via intraperitoneal injection for 3 weeks. Salvianolic acid A suppressed DNCB-induced AD-like symptoms like ear skin hypertrophy and decreased mast cell infiltration into skin lesions. Salvianolic acid A not only reduced DNCB-induced increase of serum IgE but also lowered levels of the Th2 cytokines (IL-4 and IL-13), Th1 cytokine (interferon-γ), and Th17 cytokine (IL-17A). Furthermore, salvianolic acid A blocked DNCB-induced lymph node enlargement. In summary, these results suggest that salvianolic acid A might have a therapeutic potential for the treatment of AD.

The epidemiology of atopic dermatitis in older adults: A population-based study in the United Kingdom.

Atopic dermatitis is known to be common among children, but there are few studies examining the epidemiology across the life course. In particular, there is a paucity of data on atopic dermatitis among older adults. To evaluate participant characteristics, patterns of disease activity and severity, and calendar trends in older adult atopic dermatitis in comparison to other age groups in a large population-based cohort. This was a cohort study of 9,154,936 individuals aged 0-99 years registered in The Health Improvement Network, a database comprised of electronic health records from general practices in the United Kingdom between 1994 and 2013. Atopic dermatitis was defined by a previously validated algorithm using a combination of at least one recorded atopic dermatitis diagnostic code in primary care and two atopic dermatitis therapies recorded on separate days. Cross-sectional analyses of disease prevalence were conducted at each age. Logistic mixed effect regression models were used to identify predictors of prevalent disease over time among children (0-17 years), adults (18-74 years), and older adults (75-99 years). Physician-diagnosed atopic dermatitis was identified in 894,454 individuals with the following proportions in each age group: 18.3% of children, 7.7% of adults, and 11.6% of older adults. Additionally, atopic dermatitis prevalence increased across the 2-decade period (beta from linear regression test for trend in the change in proportion per year = 0.005, p = 0.044). In older adults, atopic dermatitis was 27% less common among females (adjusted OR 0.73, 95% CI 0.70-0.76) and was more likely to be active (59.7%, 95% CI 59.5-59.9%) and of higher severity (mean annual percentage with moderate and severe disease: 31.8% and 3.0%, respectively) than in other age groups. In a large population-based cohort, the prevalence of physician-diagnosed atopic dermatitis has increased throughout adulthood and was most common among males age 75 years and above. Compared to children ages 0-17 and adults ages 18-74, older adult atopic dermatitis was more active and severe. Because the prevalence of atopic dermatitis among older adults has increased over time, additional characterization of disease triggers and mechanisms and targeted treatment recommendations are needed for this population.

The direct and indirect costs of adult atopic dermatitis.

BACKGROUND: Atopic dermatitis is considered a childhood illness, and the direct and indirect health care burden of atopic dermatitis in adults is not fully understood. OBJECTIVE: To measure the direct and indirect costs of atopic dermatitis among adults in 2018. METHODS: This retrospective cohort study compared commercial and Medicare-insured adults with atopic dermatitis in 2018 with directly matched (1:3) adults without atopic dermatitis. Atopic dermatitis prevalence was reported. Health care utilization, direct health care costs, and work loss data were compared between cohorts. This analysis was repeated for adults with atopic dermatitis in 2016 and 2017. RESULTS: 31,164 adults with atopic dermatitis in 2018 were identified and directly matched (1:3) to controls. Adults with atopic dermatitis had greater utilization of outpatient services, outpatient pharmacy services, and short-term disability benefits than controls. Unadjusted annual health care costs in 2018 were $4,979 higher for adults with atopic dermatitis ($14,603) than for the matched controls ($9,624), driven by outpatient services and pharmacy. Findings were supported by analyses of adults from 2016 and 2017 and multivariable analyses. One limitation of this study was that patients with mild cases of atopic dermatitis may not seek medical treatment and may be underrepresented in the study cohort. CONCLUSIONS: The direct health care and indirect (short-term disability) health care costs of atopic dermatitis present a significant health care burden among the adult population. DISCLOSURES: This study was funded by Eli Lilly and Company. Employees of Eli Lilly were involved in the planning, execution, and interpretation of the study. Pierce is employed by Eli Lilly and Company. Boytsov and Goldblum were employed by Eli Lilly and Company Health at the time this research was conducted. Manjelievskaia and Brouillette are employed by IBM Watson Health, which received funding from Eli Lilly and Company to conduct this study. Bonafede and Onyekwere were employed at IBM Watson Health at the time this research was conducted.

Prenatal PM2.5 affects atopic dermatitis depending on maternal anxiety and gender: COCOA study.

BackgroundThe prevalence of atopic dermatitis (AD) is increasing worldwide. Prenatal particulate matter with an aerodynamic diameter <2.5 μm (PM2.5) and maternal anxiety during pregnancy has been suggested as a potential causes of AD. This study investigated the effects of prenatal PM2.5 and maternal anxiety on AD and identified the critical period of PM2.5 exposure for AD in infants.MethodsThis study included 802 children from the COCOA birth cohort study with follow‐up data at 1 year of age. PM2.5 was estimated by land‐use regression models and prenatal anxiety was measured with a questionnaire. AD was diagnosed by doctor at 1 year of age. Logistic regression analysis and Bayesian distributed lag interaction models were applied.ResultsHigher PM2.5 during the first trimester of pregnancy, higher prenatal maternal anxiety, and male gender were associated with AD at 1 year of age (adjusted odds ratio [aOR] and 95% confidence interval [CI]: 1.86 [1.08–3.19], 1.58 [1.01–2.47], and 1.54 [1.01–2.36], respectively). Higher PM2.5 during the first trimester and higher maternal anxiety during pregnancy showed an additive effect on the risk of AD (aOR: 3.13; 95% CI: 1.56–6.28). Among boys exposed to higher maternal anxiety during pregnancy, gestational weeks 5–8 were the critical period of PM2.5 exposure for the development of AD.ConclusionsHigher PM2.5 exposure during gestational weeks 5–8 increased the probability of AD in infancy, especially in boys with higher maternal anxiety. Avoiding PM2.5 exposure and maternal anxiety from the first trimester may prevent infant AD.

Association Between Inflammatory Bowel Disease and Atopic Dermatitis: A Two-Sample Mendelian Randomization Study

To The Editors, Inflammatory bowel disease (IBD) is a type of idiopathic inflammatory disease including Crohn’s disease and ulcerative colitis. Atopic dermatitis (AD) is a common inflammatory skin disorder. Recent studies indicated that the incidence and prevalence of IBD and AD are strongly related,1 and a bidirectional relationship was found through a meta-analysis.2 Mendelian randomization (MR) is an excellent method that uses genetic variants as instrumental variables to assess causal relationships between chronic diseases. Here, we performed a 2-sample MR analysis for the association between IBD and AD. The raw data were collected from OpenGWAS database (https://gwas.mrcieu.ac.uk/). For IBD, we extracted the result of an analysis by Liu et al from 9 GWAS studies with 34,652 subjects to generate the instrumental variables (IVs; ieu-a-31).3 For AD, the data by Ishigaki et al from 28 GWAS studies with 212,036 subjects were used in the exposure datasheet...