Atopic dermatitis prevalence has been estimated at 15% to 20% in children and 1% to 3% in adults in industrialized countries.[4]Nutten S. Atopic dermatitis: global epidemiology and risk factors. Ann Nutr Metab. 2015;66 Suppl 1:8-16.
https://www.karger.com/Article/FullText/370220
http://www.ncbi.nlm.nih.gov/pubmed/25925336?tool=bestpractice.com
In the US, the prevalence of atopic dermatitis is 10% to 20% in children, and 1% to 7% in adults.[5]Leung D, Boguniewicz M, Howell MD, et al. New insights into atopic dermatitis. J Clin Invest. 2004 Mar;113(5):651-7.
https://www.jci.org/articles/view/21060
http://www.ncbi.nlm.nih.gov/pubmed/14991059?tool=bestpractice.com
[6]Chiesa Fuxench ZC, Block JK, Boguniewicz M, et al. Atopic dermatitis in America study: a cross-sectional study examining the prevalence and disease burden of atopic dermatitis in the US adult population. J Invest Dermatol. 2019 Mar;139(3):583-90.
https://www.jidonline.org/article/S0022-202X(18)32678-2/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/30389491?tool=bestpractice.com
[7]Silverberg JI, Gelfand JM, Margolis DJ, et al. Patient burden and quality of life in atopic dermatitis in US adults: a population-based cross-sectional study. Ann Allergy Asthma Immunol. 2018 Sep;121(3):340-7.
https://www.annallergy.org/article/S1081-1206(18)30567-2/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/30025911?tool=bestpractice.com
Usually presenting in childhood, 45% of patients are diagnosed by 6 months of age, and 70% to 85% by 5 years of age.[1]Spergel JM, Paller AS. Atopic dermatitis and the atopic march. J Allergy Clin Immunol. 2003 Dec;112(6 Suppl):S118-27.
http://www.ncbi.nlm.nih.gov/pubmed/14657842?tool=bestpractice.com
[4]Nutten S. Atopic dermatitis: global epidemiology and risk factors. Ann Nutr Metab. 2015;66 Suppl 1:8-16.
https://www.karger.com/Article/FullText/370220
http://www.ncbi.nlm.nih.gov/pubmed/25925336?tool=bestpractice.com
[8]Williams H. Atopic dermatitis. N Engl J Med. 2005 Jun 2;352(22):2314-24.
http://www.ncbi.nlm.nih.gov/pubmed/15930422?tool=bestpractice.com
Remission is noted by 15 years of age in 60% to 75% of cases, although relapse may occur later in life.[1]Spergel JM, Paller AS. Atopic dermatitis and the atopic march. J Allergy Clin Immunol. 2003 Dec;112(6 Suppl):S118-27.
http://www.ncbi.nlm.nih.gov/pubmed/14657842?tool=bestpractice.com
[8]Williams H. Atopic dermatitis. N Engl J Med. 2005 Jun 2;352(22):2314-24.
http://www.ncbi.nlm.nih.gov/pubmed/15930422?tool=bestpractice.com
[9]Thomsen SF. Epidemiology and natural history of atopic diseases. Eur Clin Respir J. 2015 Mar 24;2(1):24642.
https://www.tandfonline.com/doi/full/10.3402/ecrj.v2.24642
http://www.ncbi.nlm.nih.gov/pubmed/26557262?tool=bestpractice.com
One study on the global variation of atopic dermatitis reported that prevalence ranges from 0.9% (Jodhpur, India) to 22.5% (Quito, Ecuador) for children ages 6-7 years. For adolescents ages 13-14 years, the prevalence rate varied from 0.2% (Tibet, China) to 24.6% (Barranquilla, Columbia).[10]Odhiambo JA, Williams HC, Clayton TO, et al; ISAAC Phase Three Study Group. Global variations in prevalence of eczema symptoms in children from ISAAC Phase Three. J Allergy Clin Immunol. 2009 Dec;124(6):1251-8.e23.
https://www.jacionline.org/article/S0091-6749(09)01535-8/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/20004783?tool=bestpractice.com
Data suggest that rising prevalence has plateaued in countries with the highest prevalence rates (e.g., UK and New Zealand), but continues to increase in low-income countries (e.g., Latin America, Southeast Asia), especially in the 6- to 7-year age group.[11]Williams H, Stewart A, von Mutius E, et al; International Study of Asthma and Allergies in Childhood (ISAAC) Phase One and Three Study Groups. Is eczema really on the increase worldwide? J Allergy Clin Immunol. 2008 Apr;121(4):947-54.e15.
https://www.jacionline.org/article/S0091-6749(07)02212-9/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/18155278?tool=bestpractice.com
One subsequent systematic review reported 12-month atopic dermatitis prevalence of 1.8% to 17.0% in European children, and 0.94% to 22.6% in Asian children.[12]Bylund S, von Kobyletzki LB, Svalstedt M, et al. Prevalence and incidence of atopic dermatitis: a systematic review. Acta Derm Venereol. 2020 Jun 9;100(12):adv00160.
https://www.medicaljournals.se/acta/content/html/10.2340/00015555-3510
http://www.ncbi.nlm.nih.gov/pubmed/32412646?tool=bestpractice.com
Atopic dermatitis affects females more than males in both the 6-7 years and the 13-14 years of age populations.[10]Odhiambo JA, Williams HC, Clayton TO, et al; ISAAC Phase Three Study Group. Global variations in prevalence of eczema symptoms in children from ISAAC Phase Three. J Allergy Clin Immunol. 2009 Dec;124(6):1251-8.e23.
https://www.jacionline.org/article/S0091-6749(09)01535-8/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/20004783?tool=bestpractice.com
Few reports on atopic dermatitis provide detailed information regarding race or ethnicity. In studies where race or ethnicity has been reported, the subject population has included approximately 62.1% white, 18.0% black, 6.9% Asian, and 2.0% Hispanic.[13]Hirano SA, Murray SB, Harvey VM. Reporting, representation, and subgroup analysis of race and ethnicity in published clinical trials of atopic dermatitis in the United States between 2000 and 2009. Pediatr Dermatol. 2012 Nov-Dec;29(6):749-55.
http://www.ncbi.nlm.nih.gov/pubmed/23017105?tool=bestpractice.com
In the US, reported atopic dermatitis prevalence is 19.3% in African-American children and 16.1% in European-American children.[14]Brunner PM, Guttman-Yassky E. Racial differences in atopic dermatitis. Ann Allergy Asthma Immunol. 2019 May;122(5):449-55.
https://www.annallergy.org/article/S1081-1206(18)31420-0/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/30465859?tool=bestpractice.com
The prevalence and incidence of atopic dermatitis is higher in non-Hispanic black populations, compared with Hispanic and non-Hispanic white people from higher-income families. Children living in poverty also have a higher prevalence of atopic dermatitis, compared with children from higher-income families.[15]Burbank AJ, Hernandez ML, Jefferson A, et al. Environmental justice and allergic disease: a work group report of the AAAAI Environmental Exposure and Respiratory Health Committee and the Diversity, Equity and Inclusion Committee. J Allergy Clin Immunol. 2023 Mar;151(3):656-70.
https://www.jacionline.org/article/S0091-6749(22)02555-6/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/36584926?tool=bestpractice.com
One prospective cohort study reported that the rate of prevalence and persistence of atopic dermatitis was higher (14.5% to 15%) in the US for children who were female or black and from an urban environment.[16]McKenzie C, Silverberg JI. The prevalence and persistence of atopic dermatitis in urban United States children. Ann Allergy Asthma Immunol. 2019 Aug;123(2):173-8.e1.
http://www.ncbi.nlm.nih.gov/pubmed/31128232?tool=bestpractice.com
Young children exposed to less hygienic environments in resource-poor countries tend to have a lower prevalence of atopic dermatitis.[17]Flohr C, Yeo L. Atopic dermatitis and the hygiene hypothesis revisited. Curr Probl Dermatol. 2011;41:1-34.
http://www.ncbi.nlm.nih.gov/pubmed/21576944?tool=bestpractice.com
Family history plays a role in the prevalence of atopic dermatitis. Prevalence in siblings has been estimated at 22% to 24%.[18]Schultz Larsen F, Diepgen T, Svensson A. The occurrence of atopic dermatitis in north Europe: an international questionnaire study. J Am Acad Dermatol. 1996 May;34(5 pt 1):760-4.
http://www.ncbi.nlm.nih.gov/pubmed/8632070?tool=bestpractice.com
Concordance rates of 77% in monozygotic twins and 15% in dizygotic twins have been reported.[19]Meagher LJ, Wines NY, Cooper AJ. Atopic dermatitis: review of immunopathogenesis and advances in immunosuppressive therapy. Australas J Dermatol. 2002 Nov;43(4):247-54.
http://www.ncbi.nlm.nih.gov/pubmed/12423430?tool=bestpractice.com