Eczema (Atopic Dermatitis) Statistics

Eczema Prevalence

  • Approximately 31.6 million people in the United States have some form of eczema 19

Atopic Dermatitis Prevalence

  • 15-20% of children globally have AD 5
  • 15% of children in the United States have AD 15
  • 1-3% of adults globally have AD 5
  • 7.3% of adults in the United States have AD 16

 

Definition of Atopic Dermatitis

Atopic dermatitis (AD), a form of eczema, is a chronic, non-contagious, inflammatory skin condition that causes dry and itchy skin which sometimes weeps clear fluid 1

Causes of Atopic Dermatitis

The exact cause of AD is unknown, but most cases are a combination of genetics and triggers 2

  • There are several genetic factors which may lead to AD:
    • Individuals who have a parent with a history of AD, asthma, or hay fever are more likely to develop AD 3
    • Some people have a mutation in the CARD11 gene, which affects immune system cells 3
    • Some people with AD have a mutation in the gene responsible for creating filaggrin, which is a protein that helps create a healthy outer layer of skin 3
  • There are multiple things that may trigger AD symptoms including:
    • Cosmetic Products 4,5
    • Clothing 4,5
    • Dust Mites 4
    • Detergents or Soap 4
    • Weather 4,5
    • Viral Infections 4,5
    • Food allergens 5
    • Fragrances 5

Symptoms of Atopic Dermatitis

  • AD affects the skin and common symptoms include:
    • Skin itching 6
    • Dry skin 6
    • Redness 6
    • Puffy or swollen skin 6
    • Oozing or crusting from skin 6
    • Raw Skin 6
    • Thick, leathery patches of skin 6

Treatment of Atopic Dermatitis

Treatment of AD may involve a combination of nonpharmacologic and pharmacologic interventions 7

  • Non-pharmacologic
    • Skin moisturizers – should be applied after bathing 7
    • Bathing 7
    • Limit use of non-soap cleansers (should be low-pH, hypoallergenic, fragrance free) 7
    • Wet-wrap therapy 7
  • Pharmacologic (under direction of a medical provider)
    • Topical corticosteroids (if failure to respond to non-pharmacologic management) 7
    • Topical calcineurin inhibitors 7
    • Not routinely recommended for management – topical antimicrobial agents or antihistamines 7
    • Systemic immunomodulating medications 8
    • Providers may also prescribe phototherapy 8

Atopic Dermatitis Disparities

  • AD is more common in black children than other racial or ethnic groups 17
  • AD is  more common in children from families with higher incomes and education 17
  • Blacks and Asians/Pacific Islanders are more likely to seek medical care for AD 18

Atopic Dermatitis Burden

  • 91% of patients experience itching on a daily basis 12
  • 15.5% of adolescents with AD report suicidal ideation compared to 9.1% of adolescence without 13
    • This increases to 23.8% in adolescence with AD and itching 13
  • 47-60% of children with AD experience sleep disturbances 14

Economic Burden of Atopic Dermatitis

  • The total annual cost of AD increased to estimated $5.3 billion in 2015 10
    • The direct costs associated with AD were over $1 billion annually in 2004 9
      • $636 million for office visits 9
      • $154 million for prescription medications 9
      • $108 million for outpatient hospital visits 9
      • $105 million for emergency department visits 9
      • $6 million for inpatient hospital stays 9
    • The indirect costs associated with AD were $619 million in 2004 9
      • $248.5 million for caregiver lost workdays 9
      • $188.1 million for restricted activity days 9
      • $182.6 million for lost workdays 9

Per person, the average cost of treating AD is $3,302 more than for a person without the disease 11

References

  1. https://www.niaid.nih.gov/diseases-conditions/eczema-atopic-dermatitis (3/22/20)
  2. https://nationaleczema.org/eczema/causes-and-triggers-of-eczema/ (3/22/20)
  3. https://ghr.nlm.nih.gov/condition/atopic-dermatitis?_ga=2.37823587.1105300427.1584890599-498086770.1584890599#genes (3/22/20)
  4. https://www.ncbi.nlm.nih.gov/pubmed/24630429 (3/22/20)
  5. https://www.ajmc.com/journals/supplement/2017/atopic-dermatitis-focusing-on-the-patient-care-strategy-in-the-managed-care-setting (3/22/20)
  6. https://www-sciencedirect-com.libweb.ben.edu/science/article/pii/S0190962213010955?via%3Dihub (3/22/20)
  7. https://www-sciencedirect-com.libweb.ben.edu/science/article/pii/S0190962214012572?via%3Dihub#tbl2 (3/22/20
  8. https://www-sciencedirect-com.libweb.ben.edu/science/article/pii/S019096221401264X?via%3Dihub (3/22/20)
  9. https://s3.amazonaws.com/academia.edu.documents/49048409/j.jaad.2006.05.04820160922-29725-e5hno1.pdf?response-content-disposition=inline%3B%20filename%3DThe_burden_of_skin_diseases_2004.pdf&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Credential=ASIATUSBJ6BAOWAWYD7V%2F20200322%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Date=20200322T180535Z&X-Amz-Expires=3600&X-Amz-Security-Token=IQoJb3JpZ2luX2VjEDgaCXVzLWVhc3QtMSJIMEYCIQCVPc8Jo9GQRkxcdEoYZ%2Bco%2FqvxQsoDzuH3YumaxdiaGQIhAJknLkbSIEdQlRLqPn9JaSGrAdgjTxmwxxvAsA5hFEJbKrQDCDEQABoMMjUwMzE4ODExMjAwIgxBAaKKKl4xd6eXs1MqkQOOaku4YpUN6N%2BeKHOMa26tsWE7yAyaYFjbc3lIVibXZEJG4AZBwlPpsZlknuAJUqKY1LAujW2iw2gNFw3DggvLY6BE1L61ekJ6LOL8BbOU2u6HVGDQ9t4eF5SZ7lf7VQIyLax%2FhTIb8Rq9WhrkUxeS6QbAA38rf8kP%2FGDjrbX0lXudYLJ6xijiMW6Xci5RuIVNjikB311rmZ7tjf5viXaESXMQ796eonfy69v5nnErNZ9Jq5NP6sjPUGcroVv2RUjN5erLctRMYSP1FJcAWPYh6eQjim0Q9vCqmAO8FY7jFB3sVHh6id0rssX3Joq014GgBeXeG2I90npbhROujG6h23U1N8zCQIp84fB2AvJ919%2BJb4ZO791kyJLVirTQhfYi3WVLnZGqny9%2F5uw3dCAF3ePlzcJXCi10q%2F%2BIA0n8gEnRCjegcF0mC%2FSwnWIX7utDFdZVGS0xHMx1dkuW8N7zjF%2FwEBuBF3tI0HDj099d3C%2B19p1WTQAuD2wg%2Fj6dQbUT2WFcn3fx%2F%2FEx47qXnVsKJjCMmN7zBTrqAfIbUfoGk6Ah%2FD6i13nQezg1BbUqr7i5g436TRpOL7GUaeZw4kdkE2FoM8Rmp7vbBXOoT9nc2cfbBqGrBbwbKLqX0jq8eZXuF1JfblIcmJV%2FLBSR4OKsc%2Fec519g0QlA98c1jRNutu7hVTnYtbhu7NvvMmuJcDtsG8XMhpXy%2Bfmt%2Fic9HxuxY9Q2ZWPLSNPDBy415VxKWycR%2Bna0vYzSd%2FthfvFWawA4pyBOSuB9DYbWZT8HsrKx6dnkXcSJW4jXNwApgIr297mteW6aCSlaqC1kpBhupoOghAhqKLoxo0Mr9j9O6yCzp2KTeQ%3D%3D&X-Amz-SignedHeaders=host&X-Amz-Signature=c7f5394fd5acb2be832a9c446ef94b94ab82b3b5206f48b598c6fba224538718 (3/22/20)
  10. https://www.sciencedirect.com/science/article/pii/S0022202X16321200 (3/22/20)
  11. https://www.ncbi.nlm.nih.gov/pubmed/29174063 (3/22/20)
  12. https://www.ncbi.nlm.nih.gov/pubmed/19067703 (3/22/20)
  13. https://www.ncbi.nlm.nih.gov/pubmed/24496238 (3/22/20)
  14. https://onlinelibrary.wileycom.libweb.ben.edu/doi/full/10.1111/pde.13444 (3/22/20)
  15. https://www.annallergy.org/article/S1081-1206(19)30371-0/fulltext (3/22/20)
  16. https://www.ncbi.nlm.nih.gov/pubmed/30389491 (3/22/20)
  17. https://onlinelibrary.wiley.com/doi/10.1111/pde.12237 (3/22/20)
  18. https://www.ncbi.nlm.nih.gov/pubmed/12020225 (3/22/20)
  19. https://www.ncbi.nlm.nih.gov/pubmed/17498413 (3/22/20)

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