Characterizing Atopic Dermatitis in Young Adults

Prevalence of adult onset of atopic dermatitis (AD) is similar for men and women, and male sex is associated with increased odds of AD in the first year of life but decreased odds of AD in adolescence and young adulthood, according to a study published in the Journal of the European Academy of Dermatology and Venereology.

Investigators assessed the prevalence and characteristics of AD in young adults from the BAMSE project, a Swedish population-based birth cohort of 4089 infants from Stockholm. Newborn children were enrolled from 1994 to 1996 and followed up through age 24 years.

The prevalence of AD was based on questionnaire data and assessed during a 12-month period, in which 3055 individuals completed the questionnaire and were included in the analysis. Of the cohort, 543 participants (17.8%; 95% CI, 16.4%-19.1%) were determined to have had AD in the past year.

AD was significantly more prevalent in women vs men (20.5% vs 14.8%, respectively, P < .0001). Of those who participated in the clinical examination, 8.0% (95% CI, 6.8%-9.2%) had ongoing AD (women 8.5%, men 7.3%, P = .33).

For patients with AD at the 24-year follow-up, 16.9% presented with AD for the first time and had no history of AD. The percentage of participants with adult-onset AD did not differ significantly between men and women (16.4% vs 17.3%, respectively).

Significantly more women reported sleep disturbance due to itch sometimes, often, or always during the past year compared with men (26.1% vs 15.5%, respectively, P < .003). Immunoglobulin E sensitization in patients with AD occurred significantly more frequently in men vs women (79.6% vs 61.3%, respectively), P < .0001).

The mean Patient-Oriented Eczema Measure (POEM) score for all patients with ongoing AD was 8.4 (SD 5.5). POEM scores were comparable in men (mean 8.3, SD 5.8) and women (mean 8.4, SD 5.2).

The overall odds ratio for male sex was 0.90 (95% CI, 0.81-1.02), with female sex as the reference, for the entire follow-up period. The effect of male sex on having AD changed over time with significantly increased odds for AD during the first year of life (OR 1.31; 95% CI, 1.10-1.56).

Male sex was associated with reduced odds of having AD at 12 years (OR 0.64; 95% CI, 0.52-0.79), 16 years (OR 0.68, 95% CI, 0.52-0.87), and 24 years (OR 0.66, 95% CI, 0.55-0.80).

A study limitation is the absence of an investigator-based assessment of AD severity, it was noted.

“Our findings demonstrate that in some aspects, AD differs between males and females, and this is important to consider for clinicians that treat patients with AD, and for future studies of AD,” the researchers concluded.

Disclosure: Several of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Johansson EK, Bergstrom A, Kull I, et al. Prevalence and characteristics of atopic dermatitis among young adult females and males—report from the Swedish population-based study BAMSE. J Eur Acad Dermatol Venereol. Published online January 15, 2022. doi:10.1111/jdv.17929