Epidemiology

Atopic dermatitis prevalence has been estimated at 15% to 20% in children and 1% to 3% in adults in industrialized countries.[4] In the US, the prevalence of atopic dermatitis is 10% to 20% in children, and 1% to 7% in adults.[5][6][7] Usually presenting in childhood, 45% of patients are diagnosed by 6 months of age, and 70% to 85% by 5 years of age.[1][4][8]​​ Remission is noted by 15 years of age in 60% to 75% of cases, although relapse may occur later in life.[1][8][9]

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] 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] 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]

Atopic dermatitis affects females more than males in both the 6-7 years and the 13-14 years of age populations.[10]

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] In the US, reported atopic dermatitis prevalence is 19.3% in African-American children and 16.1% in European-American children.[14]

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]​ 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] Young children exposed to less hygienic environments in resource-poor countries tend to have a lower prevalence of atopic dermatitis.[17]

Family history plays a role in the prevalence of atopic dermatitis. Prevalence in siblings has been estimated at 22% to 24%.[18] Concordance rates of 77% in monozygotic twins and 15% in dizygotic twins have been reported.[19]

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