Search

Background: There are gaps in our understanding of the epidemiology of atopic dermatitis (AD) in adults. Objective: To evaluate the prevalence and severity of AD in adults from countries/regions within Asia, Eurasia, Latin America, Middle East, and Russia. Methods: This international, web-based survey was performed in Argentina, Brazil, China, Colombia, Egypt, Hong Kong, Israel, Malaysia, Mexico, Russia, Kingdom of Saudi Arabia (KSA), Singapore, Taiwan, Thailand, Turkey, and United Arab Emirates. Questionnaires were sent to adult members of online respondent panels for determination of AD and assessment of severity. A diagnosis of AD required respondents to meet the modified United Kingdom (UK) Working Party criteria and to self-report they had a physician diagnosis of AD. Severity of AD was determined using Patient-Oriented Scoring of Atopic Dermatitis (PO-SCORAD), Patient-Oriented Eczema Measure (POEM), and Patient Global Assessment (PGA). Results: Among respondents by country/region the prevalence of AD ranged from 3.4% in Israel to 33.7% in Thailand. The prevalence was generally higher in females versus males. Severity varied by scale, although regardless of scale the proportion of respondents with mild and moderate disease was higher than severe disease. PGA consistently resulted in the lowest proportion of severe AD (range 2.4% China – 10.8% Turkey) relative to PO-SCORAD (range 13.4% China – 41.6% KSA) and POEM (range 5.1% China – 16.6% Israel). Conclusions: This survey highlights the importance of AD in adults, with high prevalence and high morbidity among respondents and emphasizes that AD is not just a disease of childhood—there is disease persistence and chronicity in adults.

Antecedentes: Los datos sobre características clínicas y epidemiológicas de la dermatitis atópica son fundamentales para generar conocimiento sobre la enfermedad y su impacto socioeconómico. Objetivo: Describir las características clínicas de los pacientes de una clínica de dermatitis atópica. Métodos: Estudio observacional, retrospectivo y transversal. Se registraron datos demográficos, gravedad de la dermatitis atópica (según el Eczema Area Severity Index), fenotipo clínico, IgE sérica total, presencia de comorbilidades alérgicas y no alérgicas, así como de ansiedad y depresión mediante interrogatorio dirigido y escala de Hamilton. Se realizó estadística descriptiva e inferencial, considerando una significación estadística con p < 0.05. Resultados: Se incluyeron 187 pacientes, la edad tuvo una mediana de 12 años, con un rango de uno a 87 años. Se encontraron diferencias respecto al sexo y gravedad (p < 0.05). La dermatitis atópica leve se presentó en 57.8 %, la moderada en 20.9 % y la grave en 21.4 %. La gravedad estuvo asociada a comorbilidades alérgicas como asma (p = 0.001) y conjuntivitis alérgica (p < 0.001). La dermatitis atópica grave se asoció a ansiedad y depresión (p < 0.05), así como afectación ocular (p < 0.001). Conclusión: Lo población pediátrica es la más afectada por dermatitis atópica, pero en los adultos se observa la forma grave asociada a comorbilidades alérgicas.

Background: The diagnostic approaches and therapeutic strategies of atopic dermatitis (AD) are generally inconsistent among physicians and health institutions. Objective: To develop a consensus statement among experts to reduce the variations in practice regarding the diagnosis and treatment of patients ≥ 12 years with AD to improve their care. Methods: Systematic literature search in PubMed and GREAT. With methodological support and using the Delphi method, a formal consensus was developed among 16 experts in Dermatology and Allergology, based on the current evidence and its applicability in the Mexican context. Apart from intense electronic communication, several issues of disagreement were discussed in two face-to-face meetings. Results: The clinical experts reached consensus on 46 statements related to the definition, classification, diagnostic strategies and treatment of AD. For the diagnosis we suggest the Williams criteria and for severity scoring the SCORAD (by the doctor) and POEM (by the patient). In addition to general care and treatment education (workshops), we suggest four steps for treatment, depending on severity: 1. Topical treatment with anti-inflammatory agents (and systemic: antihistamines/antileukotrienes —low level evidence—) 2. Phototherapy, 3. Cyclosporin A and 4. Dupilumab, with the possibility of managing this biological earlier on if a fast effect is needed. In extrinsic AD we suggest evaluating the addition of allergen immunotherapy or an elimination diet, if there is an IgE-mediated respiratory or food allergy, respectively. Conclusion: The panel of experts reached consensus on relevant aspects of AD with a focus on the transcultural adaptation of recent evidence.