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Atopic dermatitis (AD) has a variable course. Its severity may fluctuate, the symptoms may persist and the disease may flare at certain climatic conditions or due to intrinsic or extrinsic factors. Understanding the long-term course can help in gauging the prognosis of the disease.
Previous concept stated that AD commences early, during infancy or childhood and may spontaneously ameliorate by adulthood. However, a large-scale, prospective study of 7,157 children enrolled in the Pediatric Eczema Elective Registry (PEER) suggested that AD commonly persists beyond adulthood.
A multicenter study followed 1,314 Germanchildren from birth through 7years of age. The results depicted that 22% had AD within the first 2 years of life. Of these, 43% were in remission by age 3, while 38% had intermittent AD and 19% had symptoms every year of the study. Meanwhile, global findings indicate AD persistence ranges in the single digits to the teens.
A systematic review and meta-analysis of 45 studies comprising 1,10,651 subjects from 15 countries found that 80% of childhood AD had at least one period of disease clearance by 8 years of age. However, less than 5% of childhood AD was persistent 20 years after diagnosis. Later-onset disease showed higher persistence.
Source: Medscape Medical News. January 06, 2022.