Prevalence and clinical features of adult atopic dermatitis in tertiary hospitals of China

Wang, Xin; Shi, Xiaodong; Li, Linfeng; Zhou, Ping; YiWei, Shen; Song, Qingkun

doi:10.1097/md.0000000000006317

Cited by 46 publications

(40 citation statements)

References 24 publications

(25 reference statements)

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“…Our findings are in line with previous studies considering AD manifestations, as pruritus, erythema and dry skin were reported by most patients [1,30,38]. A slight variance was found between patients who reported pruritus (55.1% in first visit; 41.7% in last visit) and dry skin (48.7% in first visit; 43.3% in last visit).…”

Section: Discussionsupporting

confidence: 92%

Clinical Features and Disease Management in Adult Patients With Atopic Dermatitis Receiving Care at Reference Hospitals in Brazil: the ADAPT Study

Arruda

Yang

Aoki

et al. 2021

J Investig Allergol Clin Immunol

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Background: Atopic dermatitis is a chronic inflammatory skin disease with a prevalence of 0.02% to 8.1% in adults. Adult patients with moderate-to-severe atopic dermatitis have frequent relapses and significant disease burden.Objectives: Characterize clinical, immunological and therapeutic features of Brazilian adults with atopic dermatitis.Methods: A multicenter, observational, retrospective, descriptive registry-based study, conducted at reference hospitals, between December 2016 and October 2017. Demographics, personal and family history of atopic diseases, clinical manifestations, laboratory tests, disease severity and management were collected. Results:From the 187 subjects included in the analysis, 56.1% were female and 71.7% were Caucasian, with a mean age of 24.7 years. Mean follow-up duration was 9 years. Asthma or other allergic diseases were reported by 80.2% of the patients.The main comorbidity was hypertension (10.2%) and common disease manifestations included pruritus and erythema. Lesions were generally distributed in non-flexural and flexural areas, with typical morphology. Around 83% of patients had moderate to severe disease and 8.6% reported at least one hospitalization. Most patients received topical and/or systemic pharmacological therapies, including omalizumab (5.9%); 4.3% received phototherapy. Moreover, 66.8% of patients received adjuvant therapy and 79.1% changed or discontinued treatment for atopic dermatitis due to remission (46.5%), poor effectiveness (33.7%) or lack of therapeutic adherence (12.9%). Most patients presented characteristics of type 2 inflammation, with immunoglobulin E levels above 100 IU/mL (94.4%) and peripheral blood eosinophils above 5% (55.9%). Conclusion:Brazilian adult patients with severe atopic dermatitis need treatments to efficiently control the disease and improve quality of life. RESUMENAntecedentes: La dermatitis atópica es una enfermedad inflamatoria crónica de la piel con una prevalencia, en adultos, del 0,02% al 8,1%. Los pacientes adultos con dermatitis atópica moderada o grave tienen reagudizaciones frecuentes y una sintomatología importante.Objetivos: Describir las características clínicas e inmunológicas, así como las opciones terapéuticas de los pacientes brasileños adultos con dermatitis atópica.Métodos: Estudio multicéntrico, observacional, retrospectivo, descriptivo y basado en registros, realizado en hospitales de referencia, entre diciembre de 2016 y octubre de 2017.Se recopilaron datos demográficos, antecedentes personales y familiares de enfermedades atópicas, manifestaciones clínicas, pruebas de laboratorio, gravedad y manejo de la enfermedad.Resultados: De los 187 pacientes incluidos en el análisis, el 56,1% fueron mujeres y el 71,7% caucásicos, con una edad media de 24,7 años. La duración media del seguimiento fue de 9 años. El 80,2% de los pacientes referían asma u otras enfermedades alérgicas. La principal comorbilidad fue la hipertensión (10,2%) y las manifestaciones más frecuentes de la enfermedad fueron el prurito y el eritema. Las ...

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Section: Discussionsupporting

confidence: 92%

Clinical Features and Disease Management in Adult Patients With Atopic Dermatitis Receiving Care at Reference Hospitals in Brazil: the ADAPT Study

Arruda

Yang

Aoki

et al. 2021

J Investig Allergol Clin Immunol

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“…Thus, it is possible that pre‐existing ocular disorders and a dupilumab–AD disease‐specific interaction may be responsible for this increased incidence in dupilumab‐treated patients with AD, particularly as conjunctivitis was not associated with dupilumab in trials in other type 2 diseases . Allergic conjunctivitis is a common comorbidity in asthma and allergic rhinitis, as well as in AD . Both lesional and nonlesional skin in AD are characterized by epithelial barrier dysfunction, including abnormalities in keratinocyte terminal differentiation, keratinocyte lipid production and tight junctions, which all contribute to increased transepidermal water loss .…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of ophthalmic complications increases with AD severity . Allergic conjunctivitis and other ocular surface disorders are also common comorbidities of other atopic disorders such as asthma and allergic rhinitis …”

mentioning

confidence: 99%

Conjunctivitis in dupilumab clinical trials

et al. 2019

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Summary Background Dupilumab blocks the shared receptor component for interleukin (IL)‐4 and IL‐13. It is approved in the U.S.A. for patients aged ≥ 12 years with moderate‐to‐severe atopic dermatitis (AD) uncontrolled by topical prescription medicines or who cannot use topical medicines, for patients in Japan whose AD is uncontrolled with existing therapies, for patients with moderate‐to‐severe AD in Europe who are candidates for systemic therapy and for patients aged ≥ 12 years for maintenance treatment of moderate‐to‐severe asthma uncontrolled with their current medicines. AD trials have reported increased incidence of conjunctivitis for dupilumab vs. placebo. Objectives To characterize further the occurrence and risk factors of conjunctivitis in dupilumab clinical trials. Methods We evaluated randomized placebo‐controlled trials of dupilumab in AD (n = 2629), asthma (n = 2876), chronic rhinosinusitis with nasal polyps (CRSwNP) (n = 60) and eosinophilic oesophagitis (EoE) (n = 47). Results In most AD trials, dupilumab‐treated patients had higher conjunctivitis incidence than placebo controls. Higher baseline AD severity and previous history of conjunctivitis were associated with increased conjunctivitis incidence. Conjunctivitis was mostly mild to moderate. Most cases recovered or resolved during the treatment period; two patients permanently discontinued dupilumab due to conjunctivitis or keratitis. Common treatments included ophthalmic corticosteroids, antibiotics, and antihistamines or mast cell stabilizers. Most cases were diagnosed by the investigators. In asthma and CRSwNP trials, the incidence of conjunctivitis was lower for both dupilumab and placebo than in AD trials; dupilumab did not increase the incidence compared with placebo. In the EoE trial, no patients had conjunctivitis. Conclusions Conjunctivitis was more frequent with dupilumab treatment in most AD trials. In dupilumab trials in other type 2 diseases, incidence of conjunctivitis was overall very low, and was similar for dupilumab and placebo. In AD, the incidence of conjunctivitis was associated with AD severity and prior history of conjunctivitis. The aetiology and treatment of conjunctivitis in dupilumab‐treated patients require further study. What's already known about this topic? Ocular disorders, including allergic conjunctivitis, are common in patients with atopic dermatitis (AD). In most dupilumab AD trials, dupilumab‐treated patients had higher conjunctivitis incidence than those receiving placebo. Most cases were mild to moderate and recovered or were recovering during study treatment; study treatment discontinuation due to conjunctivitis was rare. Conjunctivitis incidence was very low and similar for dupilumab and placebo in clinical trials in asthma, chronic rhinosinusitis with nasal polyps and eosinophilic oesophagitis. What does this study add? This analysis confirms and extends the results of the individual clinical trials. Baseline disease‐related factors, including AD severity, prior conjunctivitis history and certa...

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“…Although it appeared to plateau at 10-20% in many developed countries, the incidence continues to increase in many developing countries (2). The prevalence of AD in adults is reportedly approximately 10% according to United States (US) population-based studies (4), and ranges from 1.8% to 4.6% according to several Asian population-based studies (5)(6)(7)(8). With an increasing prevalence in developing countries, and as one of the most common chronic diseases in developed countries, AD is currently considered a global public health concern.…”

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confidence: 99%

Psychological Health Status and Health-related Quality of Life in Adults with Atopic Dermatitis: A Nationwide Cross-sectional Study in South Korea

B³

et al. 2018

Acta Derm Venerol

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Atopic dermatitis (AD) is a chronic inflammatory skin disorder. Patients with AD often experience psychological distress and poor health-related quality of life (HRQoL). The aim of this study was to investigate the association of several psychological health statuses and poor HRQoL in an adult population with AD in South Korea. A total of 37,578 adults who participated in the Korean National Health and Nutrition Examination Survey, a nationwide, population-based, cross-sectional health survey between 2008 and 2013 were included. HRQoL was assessed by EuroQoL (EQ) 5-dimension questionnaire and EQ-visual analogue scale scores. Multiple logistic regression analysis was performed to identify the association of stress, sleep duration, depressive mood, depression, suicidal ideation, and HRQoL with AD relative to matched controls. After adjusting in patients with AD confounding factors, stress, depressive mood, depression, suicidal ideation and poor HRQoL were significantly associated with AD. Dermatologists should be concerned with improving HRQoL and managing the psychological health status of adult patients with AD.

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Prevalence and clinical features of adult atopic dermatitis in tertiary hospitals of China

Cited by 46 publications

References 24 publications

Clinical Features and Disease Management in Adult Patients With Atopic Dermatitis Receiving Care at Reference Hospitals in Brazil: the ADAPT Study

Clinical Features and Disease Management in Adult Patients With Atopic Dermatitis Receiving Care at Reference Hospitals in Brazil: the ADAPT Study

Conjunctivitis in dupilumab clinical trials

Psychological Health Status and Health-related Quality of Life in Adults with Atopic Dermatitis: A Nationwide Cross-sectional Study in South Korea

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