The effects of season and weather on healthcare utilization among patients with atopic dermatitis

Hamann, Carsten R.; Andersen, Y.M.F.; Engebretsen, Kristiane A.; Skov, Lone; Silverberg, Jonathan I.; Egeberg, Alexander; Thyssen, Jacob P.

doi:10.1111/jdv.15023

Cited by 32 publications

(35 citation statements)

References 31 publications

(54 reference statements)

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“…Again, as previously stated, US hospitalization rates for AD were highest in the Northeast US during the winter and south during the summer . However, in Denmark, healthcare utilization was highest in the winter and spring . In healthcare cost studies, a relatively small number of hospitalizations can skew the overall cost structure attributed to seasons or any other disease‐related characteristic .…”

Section: Discussionmentioning

confidence: 76%

Atopic dermatitis: the relationship to temperature and seasonality in the United States

Fleischer

2018

Int J Dermatology

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Section: Discussionmentioning

confidence: 76%

Atopic dermatitis: the relationship to temperature and seasonality in the United States

Fleischer

2018

Int J Dermatology

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“…Moreover, children treated in alpine climate were separated from their parents and intensively monitored by the multidisciplinary treatment team. This treatment setting in alpine climate has beneficial effects on disease severity and was shown to affect the immune response (blood eosinophils, memory B cells, CD8+ T cells and Th2 cells) . Besides effects on the immune system, studies also proposed that geographical variability, with variation in UV‐R, can influence the skin barrier and the microbiome .…”

Section: Discussionmentioning

confidence: 99%

“…This treatment setting in alpine climate has beneficial effects on disease severity and was shown to affect the immune response (blood eosinophils, memory B cells, CD8+ T cells and Th2 cells). 15,19,32 Besides effects on the immune system, studies also proposed that geographical variability, with variation in UV-R, can influence the skin barrier and the microbiome. 2,33 Although this study shows a change in the skin microbiome after alpine climate treatment, we cannot prove that the observed effect is directly caused by the alpine climate or through the effect on the immune system or treatment setting.…”

Section: Discussionmentioning

confidence: 99%

The influence of treatment in alpine and moderate maritime climate on the composition of the skin microbiome in patients with difficult to treat atopic dermatitis

Mierlo

Totté

Fieten

et al. 2019

Clin Experimental Allergy

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Background The skin microbiome, characterized by an overgrowth of Staphylococcus aureus, plays an important role in the pathogenesis of atopic dermatitis (AD). Multidisciplinary treatment in alpine climate is known for its positive effect on disease severity in children with AD and can result in a different immune response compared with moderate maritime climate. However, the effect on the composition of the skin microbiome in AD is unknown. Objective To determine the effect of treatment in alpine climate and moderate maritime climate on the microbiome for lesional and non‐lesional skin in children with difficult to treat AD. Results Alpine climate treatment led to a significant change in the microbiota on lesional skin, whereas no significant change was found after moderate maritime climate. On both lesional and non‐lesional skin, we observed a significant increase in Shannon diversity and a significant decrease in both Staphylococcus abundance and S aureus load after alpine climate treatment. The decrease in S aureus was significantly larger on lesional skin following alpine climate treatment compared with moderate maritime climate treatment. Staphylococcus epidermidis load was stable over time. Conclusions and clinical relevance Alpine climate treatment leads to significant changes in the composition of the skin microbiome in children with AD, mainly caused by a reduction in the Staphylococcus genus. This study shows new perspectives in the potential mode of action for therapies in AD.

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“…19,20 Recent data from Denmark highlight that the inverse of the above weather conditions is conducive to AD flares, using healthcare utilization as a surrogate marker for exacerbations. 21 The mechanism underpinning this is likely multifactorial, with filaggrin and filaggrin breakdown products (FBP) lying at the core. Low humidity may suppress filaggrin expression via an as-yet-unidentified mechanism, 22,23 while simultaneously driving deimination and breakdown of filaggrin to increase levels of natural moisturizing factor (NMF).…”

Section: Ultraviolet Radiation Temperature and Humiditymentioning

confidence: 99%

The exposome in atopic dermatitis

Stefanovic

Flohr

Irvine

2019

Allergy

128

103

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Atopic dermatitis (AD) (syn. atopic eczema) is a chronic inflammatory skin condition, affecting up to 20% of children and 5%-10% of adults. 1,2 Current understanding of AD pathogenesis points towards a sophisticated interplay between genetic and environmental factors. The pathogenesis of AD may start in many cases with a genetically predetermined skin barrier defect, which manifests itself as dry skin. This inherent skin barrier deficit leads to an overexpression of pro-inflammatory cytokines and subsequently the activation of innate lymphocyte subsets and antigen-presenting cells (T H 2 and T H 22). IL-4 and IL-13 in particular drive eosinophil and mast cell recruitment and IL-31 secretion, a key cytokine involved in itch sensation. 3 Transcutaneous sensitization to environmental allergens and bacterial infections, in particular Staphylococcus aureus, further contributes to the barrier disruption and eczematous skin inflammation. While a genetic barrier defect is present in many, this is not a prerequisite and many pathological pathways can lead to AD. There

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The effects of season and weather on healthcare utilization among patients with atopic dermatitis

Abstract: AD healthcare utilization markers changed significantly with season. A decline in temperature correlated well with AD patients' healthcare utilization, but a causative role could not be determined with certainty.

Cited by 32 publications

References 31 publications

Atopic dermatitis: the relationship to temperature and seasonality in the United States

Atopic dermatitis: the relationship to temperature and seasonality in the United States

The influence of treatment in alpine and moderate maritime climate on the composition of the skin microbiome in patients with difficult to treat atopic dermatitis

The exposome in atopic dermatitis

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