A study by Abuabara K et al. has reported that atopic dermatitis may increase into mid-adulthood in some patients. This subtype of AD may have poorer physical and mental health.

Early-life environmental factors, like tobacco smoke exposure, were not found to be reliable predictors of increasing AD into mid-adulthood, further indicating the patient’s contemporaneous environment may have an impact on the disease course throughout life.

This study enrolled 30,905 patients from two population-based birth cohorts: the 1958 National Childhood Development Study (NCDS) and the 1970 British Cohort Study (BCS70). The Follow-up data collected via nine waves of standardized questionnaires between 1958 and 2016 were utilized, followed by identification of the subtypes of atopic eczema patterns based on parent-reported or self-reported atopic eczema period prevalence.

Four disease subtypes were identified based on probability of reporting prevalent AD into midlife: 

• Low (88%-91%),
• Decreasing (4%),
• Increasing (2%-6%), and
• Persistently high (2%-3%) probability.

Further analysis also explained the associations between adult AD subtypes and other health outcomes. Like adults in the high probability-group reported rhinitis and asthma more significantly than adults in the low probability group. Also, the adults with the increasing subtype showed an elevated rate of asthma and rhinitis, accompanying worse self-reported mental health at age 42 and poor general health at age 46/50.

Thus this newly identified subtype with increasing probability of activity in adulthood demands additional attention since it is associated with poor self-reported physical and mental health in midlife.

Dr. Sidbury, a chief dermatologist at Seattle Children’s Hospital has reported that up to 10% of children with AD may have disease activity into adulthood, according to the available data. The aforementioned findings also indicate that AD is a systemic disease and underlying immune dysregulation may have serious health consequences later in life.