Phenotypic differences of atopic dermatitis stratified by age

Authors

Sheena Chatrath, Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
Jonathan I. Silverberg, Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.

Document Type

Journal Article

Publication Date

6-1-2023

Journal

JAAD international

Volume

11

DOI

10.1016/j.jdin.2022.08.026

Keywords

AD, atopic dermatitis; Atopic dermatitis; eczema; patient-reported outcomes; physical activity; severity

Abstract

BACKGROUND: Atopic dermatitis (AD) is common across all ages. Understanding heterogeneous age-related phenotypes may improve AD management. OBJECTIVE: To determine age-related clinical phenotypes of AD. METHODS: A prospective, dermatology practice-based study was performed ( = 380). AD severity was evaluated using questionnaires and full-body examination. Phenotypes were determined using latent class analysis. RESULTS: There were 23 (6.1%) pediatric patients (<18 years), 176 (46.3%) young adults (18-39 years), and 181 (47.6%) older adults (≥ 40 years). Both young and older adults experienced less AD on ankles (adjusted odds ratio [95% confidence interval]: 0.41 [0.19-0.90], 0.43 [0.20-0.94]), moderate-severe AD on flexures (0.47 [0.26-0.87], 0.30 [0.16-0.56]), pityriasis alba (0.24 [0.11-0.52], 0.07 [0.03-0.18]), oozing lesions (0.44 [0.25-0.79], 0.35 [0.20-0.63]), moderate-severe excoriations (0.49 [0.28-0.85], 0.44 [0.26-0.76]), and severe itch (adjusted β [95% confidence interval], -1.46 [-2.63 to -0.29]; -1.79 [-2.94 to -0.65]) compared with pediatric patients. Young adults experienced more AD around the eyes (2.92 [1.21-7.02]). Older adults experienced more AD on elbows (0.34 [0.19-0.64]), nipples (0.40 [0.16-0.99]), knees (0.27 [0.14-0.53]), keratosis pilaris (0.38 [0.15-0.98]), and lichenification (0.47 [0.22-0.98]). Four classes were identified for distribution of AD and associated signs. CONCLUSION: Distinct phenotypes exist by age with younger patients experiencing more AD signs and symptoms. Clinicians should consider them when managing AD.

APA Citation

Chatrath, Sheena and Silverberg, Jonathan I., "Phenotypic differences of atopic dermatitis stratified by age" (2023). GW Authored Works. Paper 2826.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/2826

Department

Dermatology