Silverberg JI, et al. - This study was implemented to gain insight into the associations and clinical characteristics of adult-onset atopic dermatitis (AD). A common prevalence of self-reported adult-onset AD was reported. In findings, in addition to distinct phenotypes, lesional predilection for the hands and/or head/neck was also highlighted.

Methods

• Using standardized questionnaires and examination, researchers performed a prospective study including 356 adults with AD (age ≥18 years).
• They evaluated AD severity using the Patient-Oriented Eczema Measure, Eczema Area and Severity Index, Scoring Atopic Dermatitis, body surface area, and numeric rating scale for itch and sleeplessness.
• They determined dominant clinical phenotypes using latent class analysis.
• Furthermore, they determined the link between adult-onset AD and distinct phenotypes using multivariate logistic regression.

Results

• Data showed that during adulthood, onset of AD was reported by a total of 149 adults (41.9%), with 87 (24.4%) after the age of 50 years.
• Researchers found that adult- vs childhood-onset AD was associated with birthplace outside the United States (χ², P=.0008), but not sex, race/ethnicity, current smoking status, or alcohol consumption (P ≥ .11); and decreased personal history of asthma, hay fever, and food allergy and family history of asthma and food allergy (P ≤ .0001 for all).
• Between adult- and childhood-onset AD, no significant difference was evident in the Eczema Area and Severity Index, Scoring Atopic Dermatitis, body surface area, numeric rating scale for itch and sleeplessness, or Patient-Oriented Eczema Measure (Mann-Whitney U test, P ≥ .10).
• The following 3 classes were identified by latent class analysis
• high probability of flexural dermatitis and xerosis with intermediate to high probabilities of head, neck, and hand dermatitis;
• high probability of flexural dermatitis and xerosis, but low probabilities of head, neck, and hand dermatitis;
• lower probability of flexural dermatitis, but the highest probabilities of virtually all other signs and symptoms.
• Findings demonstrated a significant association of adult-onset AD with class 1 (multivariate logistic regression; adjusted odds ratio, 5.54; 95% CI, 1.59-19.28) and class 3 (adjusted odds ratio, 14.03; 95% CI, 2.33-85.50).