Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Umeå, Sweden.
Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
Br J Dermatol. 2024 Jan 23;190(2):191-198. doi: 10.1093/bjd/ljad370.
The prevalence of atopic dermatitis (AD) has increased over several decades and now affects about one-fifth of all children in high-income countries (HICs). While the increase continues in lower-income countries, the prevalence of AD might have reached a plateau in HICs.
To investigate trends in the prevalence of AD and atopic comorbidity in schoolchildren in Sweden.
The study population consisted of three cohorts of children (median age 8 years) in Norrbotten, Sweden, for 1996 (n = 3430), 2006 (n = 2585) and 2017 (n = 2785). An identical questionnaire that included questions from the International Study of Asthma and Allergies in Childhood (ISAAC) protocol was used in all three cohorts. Trends in AD prevalence were estimated, as well as trends in atopic comorbidity. AD prevalence was estimated both according to the ISAAC definition of AD and by adding the reported diagnosis by a physician (D-AD).
The prevalence of AD decreased in the last decade, from 22.8% (1996) and 21.3% (2006) to 16.3% (2017; P < 0.001). The prevalence of D-AD was lower, but the same pattern of decrease was seen, from 9.3% (1996) and 9.4% (2006) to 5.7% (2017; P < 0.001). In all three cohorts, AD was more common among girls than boys (18.9% vs. 13.8% in 2017; P < 0.001). Children from the mountain inlands had a higher prevalence of AD than children from coastal cities (22.0% vs. 15.1% in 2017; P < 0.001). In comparing D-AD, there were no significant differences between the sexes or between inland or coastal living. Concomitant asthma increased over the years from 12.2% (1996) to 15.8% (2006) to 23.0% (2017; P < 0.001). Concomitant allergic rhinitis and allergic sensitization increased from 1996 (15.0% and 27.5%) to 2006 (24.7% and 49.5%) but then levelled off until 2017 (21.0% and 46.7%).
The prevalence of AD among schoolchildren in Sweden decreased over the study period, whereas atopic comorbidity among children with AD increased. Although a decrease was seen, AD is still common and the increase in atopic comorbidity among children with AD, especially the increase in asthma, is concerning.
特应性皮炎（AD）的患病率在过去几十年中有所增加，现在影响了高收入国家（HICs）五分之一的儿童。虽然在低收入国家仍在继续增加，但 AD 的患病率可能在 HICs 中已达到稳定水平。
研究瑞典学龄儿童 AD 及特应性共病的流行趋势。
研究人群为瑞典诺尔兰的三个学龄儿童队列（中位数年龄 8 岁），分别为 1996 年（n=3430）、2006 年（n=2585）和 2017 年（n=2785）。所有三个队列均使用相同的问卷，其中包括来自国际儿童哮喘和过敏研究（ISAAC）方案的问题。我们估计了 AD 患病率的变化趋势，以及特应性共病的变化趋势。AD 患病率的估计既依据 ISAAC 对 AD 的定义，也依据医生报告的诊断（D-AD）。
AD 的患病率在上一个十年中有所下降，从 1996 年的 22.8%和 2006 年的 21.3%降至 2017 年的 16.3%（P<0.001）。D-AD 的患病率虽然较低，但也呈现出同样的下降趋势，从 1996 年的 9.3%和 2006 年的 9.4%降至 2017 年的 5.7%（P<0.001）。在所有三个队列中，女孩的 AD 患病率均高于男孩（2017 年分别为 18.9%和 13.8%；P<0.001）。与沿海城市相比，来自内陆山区的儿童 AD 患病率更高（2017 年分别为 22.0%和 15.1%；P<0.001）。在比较 D-AD 时，男女之间以及内陆和沿海生活之间均无显著差异。同时患有哮喘的儿童比例逐年增加，从 1996 年的 12.2%增加到 2006 年的 15.8%，再增加到 2017 年的 23.0%（P<0.001）。同时患有过敏性鼻炎和过敏致敏的儿童比例从 1996 年的 15.0%和 27.5%增加到 2006 年的 24.7%和 49.5%，但随后到 2017 年稳定在 21.0%和 46.7%。
瑞典学龄儿童 AD 的患病率在研究期间有所下降，而患有 AD 的儿童的特应性共病有所增加。尽管有所下降，但 AD 仍然很常见，且患有 AD 的儿童的特应性共病，特别是哮喘的增加，令人担忧。
