New insights into the epidemiology of childhood atopic dermatitis

Authors

  • C. Flohr,

    Corresponding author
    1. Departments of Paediatric Dermatology & Children's Allergies, St John's Institute of Dermatology, Guy's and St Thomas’ Hospitals NHS Foundation Trust and King's College, London, UK
    • Correspondence

      Dr. Carsten Flohr, MD, MSc, PhD, Departments of Paediatric Dermatology & Children's Allergies, St John's Institute of Dermatology, St Thomas’ Hospital and King's College London, London SE1 7EH, UK.

      Tel.: +44 (0)20 7188 7188, ext 51601

      Fax: +44 (0)20 7188 9782

      E-mail: carsten.flohr@kcl.ac.uk

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  • J. Mann

    1. Department of Dermatology, Medway NHS Foundation Trust, Medway Maritime Hospital, Gillingham, Kent, UK
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  • Edited by: Stephan Weidinger

Abstract

There is a growing desire to explain the worldwide rise in the prevalence of atopic dermatitis (AD). Trend data on the burden of AD suggest that the picture in the developing world may soon resemble that of wealthier nations, where AD affects over 20% of children. This, combined with significant variations in prevalence within countries, emphasizes the importance of environmental factors. Many hypotheses have been explored, from the modulation of immune priming by hygiene, gut microbiota diversity, and exposure to endotoxins through farm animals to the effects of pollution, climate, and diet. The discovery of the filaggrin skin barrier gene and its importance in AD development and severity has brought the focus on gene–environment interactions and the identification of environmental factors that impact on skin barrier function. This article reviews our current understanding of the epidemiology of AD, with an emphasis on the findings reported in the international literature over the last 5 years.

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