Leshem Yael A, Weil Clara, Busse William W, Beck Lisa A, Chodick Gabriel, Cyr Sonya L, Bosman Kwinten, Lubwama Robert
Division of Dermatology, Rabin Medical Center, Petach Tikva, Israel.
Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Dermatol Ther (Heidelb). 2025 Sep 12. doi: 10.1007/s13555-025-01522-y.
Patients with atopic dermatitis (AD) have a high atopic comorbidity burden. Although traditionally seen as beginning with AD and progressing to other atopic comorbidities, the "atopic march" model does not fit all patients. This manuscript describes the onset of atopic comorbidities among children newly diagnosed with AD.
This retrospective, observational, cohort study used data from the Israeli Maccabi Healthcare Services. Patients (< 18 years) first diagnosed with AD during 2000-2019 with ≥ 12-month enrollment before and after AD diagnosis were included. Outcomes included cumulative asthma, allergic rhinitis (AR), and food allergy (FA) prevalence. Patients were grouped by age at AD diagnosis (< 3, 3-5, 6-11, and 12-17 years).
Of 177,081 included patients, 60.4% were < 3 years old at AD diagnosis. The baseline asthma prevalence (at or before AD diagnosis) was lower in children aged < 3 versus ≥ 3 years at AD diagnosis (10.6% versus 26.3-28.5%). The baseline AR prevalence increased with age from 2.2% (< 3 years) to 23.2% (12-17 years), while FA decreased from 4.9% (< 3 years) to 2.1% (12-17 years). Cumulative asthma and FA prevalence increased sharply in the year following AD diagnosis among children diagnosed at < 3 years old. The cumulative ≥ 1 asthma/AR/FA prevalence increased to approximately 50% by 10 years after AD diagnosis.
Children diagnosed with AD at an early age mostly acquire atopic comorbidities within 1 year following AD diagnosis, while children diagnosed later have often already developed them. Eventually, all pediatric patients with AD display a similar, significant burden of atopic multimorbidity. Graphical abstract available for this article.
Not applicable.
特应性皮炎（AD）患者有较高的特应性合并症负担。尽管传统上认为是先出现AD，然后发展为其他特应性合并症，但“特应性进程”模型并不适用于所有患者。本文描述了新诊断为AD的儿童中特应性合并症的发病情况。
这项回顾性观察队列研究使用了以色列马卡比医疗服务公司的数据。纳入2000 - 2019年首次诊断为AD且在AD诊断前后登记≥12个月的患者（<18岁）。结局包括累积哮喘、过敏性鼻炎（AR）和食物过敏（FA）患病率。患者按AD诊断时的年龄分组（<3岁、3 - 5岁、6 - 11岁和12 - 17岁）。
在纳入的177,081例患者中，60.4%在AD诊断时年龄<3岁。AD诊断时年龄<3岁的儿童与≥3岁的儿童相比，基线哮喘患病率（在AD诊断时或之前）较低（10.6%对26.3 - 28.5%）。基线AR患病率随年龄增长从2.2%（<3岁）升至23.2%（12 - 17岁），而FA从4.9%（<3岁）降至2.1%（12 - 17岁）。在<3岁时诊断为AD的儿童中，AD诊断后1年内累积哮喘和FA患病率急剧上升。AD诊断后10年时，累积≥1种哮喘/AR/FA患病率增至约50%。
早期诊断为AD的儿童大多在AD诊断后1年内患上特应性合并症，而较晚诊断的儿童往往已经患有这些疾病。最终，所有患AD的儿科患者都表现出相似的、显著的特应性多种合并症负担。本文有图形摘要。
不适用。
