Atopic dermatitis (AD) is a common illness of childhood.
To evaluate the natural history of AD and determine the persistence of symptoms over time.
Design, Setting, and Participants
A cross-sectional and cohort study of a nation-wide long-term registry of children with AD enrolled in the Pediatric Eczema Elective Registry (PEER).
Main Outcomes and Measures
Self-reported outcome of whether a child’s skin was AD symptom–free for 6 months at 6-month intervals.
A total of 7157 patients were enrolled in the PEER study for a total of 22 550 person-years. At least 2 years of follow-up were observed for 4248 children and at least 5 years of follow-up were observed for 2416 children. Multiple demographic and exposure variables were associated with more persistent AD. At every age (ie, 2-26 years), more than 80% of PEER participants had symptoms of AD and/or were using medication to treat their AD. It was not until age 20 years that 50% of patients had at least 1 lifetime 6-month symptom- and treatment-free period.
Conclusions and Relevance
Based on this large longitudinal cohort study, symptoms associated with AD seem to persist well into the second decade of a child’s life and likely longer. Atopic dermatitis is probably a life-long illness.
Locations of zip codes inhabited by at least 1 PEER study enrollee.
A Kaplan-Meier curve demonstrating the proportion of individuals with at least 5 years of follow-up at a given age who ever reported a 6-month symptom-free and medication-free period (A) and the proportion of enrollees at a given age who reported no symptoms of AD and medication use in the previous 6 months (B).
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