AAD Guidelines: awareness of comorbidities associated with atopic dermatitis in adults


Dawn M. Davis, Departments of Dermatology and Pediatrics, Mayo Clinic, Rochester, Minnesota.
Aaron M. Drucker, Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
Ali Alikhan, Department of Dermatology, Sutter Medical Foundation, Sacramento, California.
Lionel Bercovitch, Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
David E. Cohen, The Ronald O. Perelman Department of Dermatology, New York University, New York.
Jennifer M. Darr, Department of Pediatrics, National Jewish Health, Denver, Colorado.
Lawrence F. Eichenfield, University of California, San Diego and Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego, California.
Lindsy Frazer-Green, American Academy of Dermatology, Rosemont, Illinois. Electronic address: lfrazer-green@aad.org.
Amy S. Paller, Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Jonathan I. Silverberg, Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC.
Anne Marie Singh, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Robert Sidbury, Division of Dermatology, Department of Pediatrics, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, Washington.

Document Type

Journal Article

Publication Date



Journal of the American Academy of Dermatology




alcohol; allergies; atopic dermatitis; cardiovascular disease; comorbidities; dermatology; diabetes; guidelines; mental health; metabolic syndrome; obesity; osteoporosis; skin infection


BACKGROUND: Studies found associations between atopic dermatitis (AD) and many comorbidities. OBJECTIVE: To appraise evidence of the association between AD and comorbidities among adults. METHODS: Our multidisciplinary work group conducted a systematic review of the association between AD and selected comorbidities. We applied the GRADE for prognosis approach for assessing the certainty of the evidence, providing statements of association based on the available evidence. RESULTS: Analysis of the evidence resulted in 32 statements. Clear evidence of the association of AD in adults and select allergic, atopic, immune-mediated, mental health and bone health conditions and skin infections was identified. There is some evidence supporting an association between AD and substance use, ADHD, and elements of metabolic syndrome. Evidence suggests a small association with various cardiovascular conditions. The association between AD in adults and autism spectrum disorders, myocardial infarction, stroke, and metabolic syndrome is inconclusive. LIMITATIONS: This analysis is based on the best available evidence at the time it was conducted. This guideline does not make recommendations for screening or management of comorbidities in adults with AD. CONCLUSIONS: Clinicians should be aware of comorbidities associated with AD. Further research is needed to determine whether screening or management of comorbidities is beneficial for adults with AD.