Sinéad Máire Langan, FRCP, MSc, PhD

Atopic dermatitis (AD) trends based on income and region over 3 decades for children and adolescent patients showed that high-income countries experienced 10-year increases for this group, according to new findings.¹

Given that atopic dermatitis/eczema affects much of the world, the study’s investigators sought to examine the skin condition’s prevalence over time through a standardized methodology.

The study was authored by Sinéad Máire Langan, FRCP, MSc, PhD, from the London School of Hygiene & Tropical Medicine in the United Kingdom.

“The goal of the current study was to understand trends in the presence of eczema symptoms (referred to as burden) globally from 1993 to 2020, using the same methods as the ISAAC study, now incorporated into (Global Asthma Network),” Langan and colleagues wrote.

Background and Findings

The investigators Global Asthma Network (GAN) Phase I study data collected from 27 centers in 14 different countries. The data collected by the team involved 74,361 adolescent patients in the 13 to 14 age bracket and 47,907 children in the 6 to 7 age bracket.

The GAN Phase I study is an international collaborative study which came from the International Study of Asthma and Allergies in Children (ISAAC), a global study which examined international trends in the prevalence of asthma, eczema, and rhinoconjunctivitis.

ISAAC helped to bring useful insights for clinicians into eczema burdens at a global scale over 20 years.

The investigators used survey data from these studies to assess the prevalence, lifetime prevalence, and severity of AD through 27 of the centers which took part in 1 or both of ISAAC Phase I (1993 to 1995) and Phase III (2001 to 2003) and in GAN Phase I (2015 to 2020).

The research team used fitted, linear, mixed models for their evaluation of 10-year trends in prevalence by age group, region, and income bracket.

The research team found there was a median of 6% of children and adolescent patients who reported current AD symptoms, noting that rates were 1.1% for adolescents and 0.6% for children.

The investigators determined a small 10-year increase in current eczema prevalence was visible, after adjusting for both region and income level. They noted the increase for adolescents (0.98%, 95% CI, 0.04% to 1.92%) and for children (1.21%, 95% CI, 0.18% to 2.24%).

The team also noted a change in severe eczema for adolescents (0.26%, 95% CI, 0.06% to 0.46%) and for children (0.23%, 95% CI, 0.02% to 0.45%). The investigators added that they found bigger rises in prevalence over lifetime in adolescents (2.71%, 95% CI, 1.10% to 4.32%) and in children (3.91%, 95% CI, 2.07% to 5.75%).

The investigators also added that there were rises in certain outcomes for children in the high-income bracket and adolescents in the middle-income bracket, noting substantial heterogeneity (standard deviations 2.40%, 0.58%, and 3.04%) in changes over 10 years between the different centers

“We identified a substantial burden of eczema globally,” they wrote. “Our data support an overall increase in the prevalence of eczema and severe eczema globally, but with substantial variation by geographical location and income as well as other factors unexplained by our modelling.”

References:

1. Langan, SM, Mulick, AR, Rutter, CE, et al. Trends in eczema prevalence in children and adolescents: A Global Asthma Network Phase I Study. Clin Exp Allergy. 2023; 00: 1- 16. doi:10.1111/cea.14276.