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Observational Study
. 2014 Jun;150(6):593-600.
doi: 10.1001/jamadermatol.2013.10271.

Persistence of mild to moderate atopic dermatitis

Jacob S Margolis  1 , Katrina Abuabara  2 , Warren Bilker  1 , Ole Hoffstad  1 , David J Margolis  2
Affiliations
Observational Study

Persistence of mild to moderate atopic dermatitis

Jacob S Margolis et al. JAMA Dermatol. 2014 Jun.

Abstract

Importance: Atopic dermatitis (AD) is a common illness of childhood.

Objective: To evaluate the natural history of AD and determine the persistence of symptoms over time.

Design, setting, and participants: A cross-sectional and cohort study of a nation-wide long-term registry of children with AD enrolled in the Pediatric Eczema Elective Registry (PEER).

Main outcomes and measures: Self-reported outcome of whether a child's skin was AD symptom-free for 6 months at 6-month intervals.

Results: A total of 7157 patients were enrolled in the PEER study for a total of 22,550 person-years. At least 2 years of follow-up were observed for 4248 children and at least 5 years of follow-up were observed for 2416 children. Multiple demographic and exposure variables were associated with more persistent AD. At every age (ie, 2-26 years), more than 80% of PEER participants had symptoms of AD and/or were using medication to treat their AD. It was not until age 20 years that 50% of patients had at least 1 lifetime 6-month symptom- and treatment-free period.

Conclusions and relevance: Based on this large longitudinal cohort study, symptoms associated with AD seem to persist well into the second decade of a child's life and likely longer. Atopic dermatitis is probably a life-long illness.

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Conflict of interest statement

The authors have no relevant conflicts of interest regarding this manuscript.

Figures

Figure 1
Figure 1
PEER locations: Zip codes inhabited by at least one PEER enrollee.
Figure 2
Figure 2
Persistence of AD by age: A Kaplan-Meir curve demonstrating the proportion of individuals with at least 5-years of follow at a given age who ever reported a 6-month symptom free and medication free period (A) and the proportion of enrollees at a given age who reported no symptoms of AD and medication use in the previous 6-months (B).
Figure 2
Figure 2
Persistence of AD by age: A Kaplan-Meir curve demonstrating the proportion of individuals with at least 5-years of follow at a given age who ever reported a 6-month symptom free and medication free period (A) and the proportion of enrollees at a given age who reported no symptoms of AD and medication use in the previous 6-months (B).
See this image and copyright information in PMC

Comment in

References

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