Distinct Features Identified in Adult Atopic Dermatitis Subjects Based on Age of Onset
Sunday, March 6, 2016: 3:00 PM
Room 515A (Convention Center)
Peck Y. Ong, MD FAAAAI, , , , , , , , , , , , , ,
Rationale: Atopic dermatitis (AD) is an inflammatory skin condition consisting of heterogeneous phenotypes.  We aimed to characterize age of AD onset phenotypes in three populations: European Americans (EA), African Americans (AA) and Mexican Americans (MA).

Methods: Eight NIAID-funded Atopic Dermatitis Research Network sites enrolled 1530 AD adults (≥19 y).  Medical history, physical examination, eosinophil counts, serum IgE, aeroallergen panel, and filaggrin null mutations (FLG) were obtained.  Subjects were categorized according to age of AD onset (≤5 y, 6-18 y and ≥19 y). Eczema Area and Severity Index (EASI), Rajka-Langeland severity score, past staphylococcal infection, past eczema herpeticum (EH) and laboratory test results were compared amongst the age of AD onset groups. All analyses were adjusted for potential confounders.

Results: The analysis included 759 EA, 429 AA and 103 MA. There was no significant difference in the prevalence of age of AD onset groups by race.  The ≤5 y group for both EA and AA showed significantly higher total serum IgE and higher prevalence of positive aeroallergen IgE panel compared to the ≥19 y group (P<.0001).  Additionally, the ≤5 y EA group had significantly higher EASI, Rajka-Langeland scores, absolute eosinophils as well as higher prevalence of past staph infections and past EH compared to the ≥19 y EA group (P<.0001). In EA subjects, the prevalence of ≤5 y onset was higher in subjects with FLGmutations than in those without (P<.0001).

Conclusions: Our results showed distinct phenotypes based on age of onset for the ≤5 y and ≥19 y groups, particularly in the EA population.