Patients with adult- and late childhood-onset atopic dermatitis report a higher burden of disease severity than patients with early childhood-onset atopic dermatitis.

RATIONALE: The disease severity of early childhood-onset AD (COAD) has been reported to be higher than that of adult-onset AD (AOAD). However, the disease burden of these patients has not been compared. We used a nation-wide, web-based, population survey and patient-reported outcomes (PRO) to address this question.

METHODS: The GfK Knowledge Panel was used. Of the 8,217 adult subjects who completed the interviews, 602 fulfilled a modified UK Diagnostic Criteria: an itchy skin condition in the past year, and at least 3 of the following: onset under 2y, h/o flexural involvement, h/o generally dry skin, and personal h/o asthma or hayfever. Subjects were further divided based on self-reported age of AD onset: <6y (early COAD), 6-17y (late COAD) and ≥18y (AOAD). PRO instruments included Patient Oriented Eczema Measure (POEM), Patient Oriented-Scoring Atopic Dermatitis (PO-SCORAD), Dermatology Life Quality Index (DLQI) and the Hospital Anxiety and Depression Scale (HADS) scores.

RESULTS: No significant differences in POEM and PO-SCORAD were observed between the 3 groups (mean POEM 7.56, 7.95 and 7, respectively; mean PO-SCORAD 23.83, 28.33 and 25.98, respectively). HADS depression scores were significantly higher in AOAD, as compared to early COAD (5.88 [95%CI 5.45-6.31] vs 4.9 [4.05-5.75])(p<0.05). DLQI scores were significantly higher in the late COAD group compared with early COAD and AOAD (5.33 [3.99-6.66] vs 3.72 [2.53-4.91] and 4.05 [3.51-4.61], respectively)(p<0.05).

CONCLUSIONS: AOAD and late COAD had similar patient reported AD severity, but a higher disease burden compared to early COAD. These results may be confounded due to univariate analysis.