Background

Previous studies found conflicting results about whether atopic dermatitis (AD) begins in adulthood.

Objective

To determine rates, predictors, and phenotypic differences of adult-onset AD.

Methods

A systematic review was performed with all published observational studies in Medline, Embase, GREAT (Global Resource of EczemA Trials), LILACS (Latin American and Caribbean Health Sciences Literature), Cochrane Library, and Scopus that analyzed the age of AD onset beyond 10 years of age. At least two reviewers performed study title, abstract review, and data extraction. Pooled meta-analysis of the proportion of adult-onset AD was performed by using random-effects weighting (I² = 99.3%).

Results

Overall, 25 studies met inclusion criteria. Seventeen studies reported age of AD onset as after 16 years of age and had sufficient data for meta-analysis. The pooled proportion (95% confidence interval) of adult-onset AD was 26.1% (16.5%-37.2%). Similar results were found in sensitivity analyses by AD diagnostic method, study region, and sex. Phenotypic differences were observed across studies for adult-onset and child-onset AD, including higher rates of foot dermatitis and personal history of atopy but lower rates of flexural lesions and other signs and symptoms.

Limitations

Characteristics of adult-onset versus child-onset AD were not commonly reported.

Conclusion

AD is not only a disease of childhood; 1 in 4 adults with AD report adult-onset disease, which has distinct clinical characteristics as compared to child-onset AD.

中文翻译：

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对成人发病性特应性皮炎的患病率和表型进行系统的回顾和荟萃分析

背景

先前的研究发现异位性皮炎（AD）是否在成年后开始出现矛盾的结果。

客观的

为了确定成人发病AD的发生率，预测指标和表型差异。

方法

在Medline，Embase，GREAT（EczemA试验的全球资源），LILACS（拉丁美洲和加勒比健康科学文献），Cochrane图书馆和Scopus中所有已发表的观察性研究中进行了系统的综述，分析了AD发病的年龄超过10年。年龄。至少有两名审稿人进行了研究标题，摘要审阅和数据提取。使用随机效应权重（I ²  = 99.3％）对成年发作性AD的比例进行汇总荟萃分析。

结果

总体而言，有25项研究符合纳入标准。十七项研究报道了16岁以后的AD发病年龄，并且有足够的数据进行荟萃分析。成年AD的合并比例（95％置信区间）为26.1％（16.5％-37.2％）。在通过AD诊断方法，研究区域和性别进行的敏感性分析中也发现了相似的结果。在成年期和儿童期AD研究中观察到表型差异，包括足部皮炎的发生率和个人特应性病史，但是挠曲性病变和其他体征和症状的发生率较低。

局限性

成人发作与儿童发作AD的特征并不普遍报道。

结论

AD不仅是儿童疾病。四分之一的成人AD患者报告成人发病，与儿童AD相比，该疾病具有明显的临床特征。