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The burden of childhood atopic dermatitis in the primary care setting: a report from the Meta-LARC Consortium

Al-Naqeeb, Jinan; Danner, Sankirtana; Fagnan, Lyle J.; Ramsey, Katrina; Michaels, LeAnn; Mitchell, Julie; Branca, Kelsey; Morris, Cynthia; Nease, Donald E.; Zittleman, Linda; Levy, Barcey; Daly, Jeanette; Hahn, David; Dolor, Rowena J.; Williams, Hywel C.; Chalmers, Joanne R.; Hanifin, Jon; Tofte, Susan; Zuckerman, Katharine E.; Hansis, Karen; Gundersen, Mollie; Block, Julie; Karr, Francie; Dunbrasky, Sandra; Siebe, Kathy; Dillon, Kristen; Cibotti, Ricardo; Lapidus, Jodi; Simpson, Eric L.

Authors

Jinan Al-Naqeeb

Linda Zittleman

Barcey Levy

Jeanette Daly

David Hahn

Rowena J. Dolor

Hywel C. Williams

Joanne R. Chalmers

Jon Hanifin

Susan Tofte

Katharine E. Zuckerman

Sankirtana Danner

Karen Hansis

Mollie Gundersen

Julie Block

Francie Karr

Sandra Dunbrasky

Kathy Siebe

Kristen Dillon

Ricardo Cibotti

Jodi Lapidus

Eric L. Simpson

Lyle J. Fagnan

Katrina Ramsey

LeAnn Michaels

Julie Mitchell

Kelsey Branca

Cynthia Morris

Donald E. Nease

Abstract

Background: Little is known about the burden of AD encountered in U.S. primary care practices and the frequency and type of skin care practices routinely used in children.
Objectives: To estimate the prevalence of AD and allergic comorbidities in children 0-5 years attending primary care practices in the U.S. and to describe routine skin care practices used in this population.
Design: A cross-sectional survey study of a convenience sample of children under the age of 5 attending primary care practices for any reason.
Setting: Ten primary care practices in five U.S. states.
Results: Amongst 652 children attending primary care practices, the estimated prevalence of ever having AD was 24 % (95% CI= 21-28) ranging from 15% among those under the age of one to 38% among those aged 4- 5 years. The prevalence of comorbid asthma was higher among AD participants compared to those with no AD, 12% and 4%, respectively (p less than 0.001). Moisturizers with high water:oil ratios were most commonly used (i.e., lotions) in the non-AD population, whereas moisturizers with low water:oil content (i.e. ointments) most common when AD was present.
Conclusions: Our study found a large burden of AD in the primary care practice setting in the U.S. The majority of households reported skin care practices in children without AD that may be detrimental to the skin barrier such as frequent bathing and the routine use of moisturizers with high water: oil ratios. Clinical trials are needed to identify which skin care practices are optimal for reducing the significant risk of AD in the community.

Journal Article Type Article
Publication Date Apr 1, 2019
Journal Journal of the American Board of Family Medicine
Print ISSN 1557-2625
Publisher American Board of Family Medicine
Peer Reviewed Peer Reviewed
Volume 32
Issue 2
Pages 191-200
DOI https://doi.org/10.3122/jabfm.2019.02.180225
Publisher URL https://www.jabfm.org/content/32/2/191

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