Age-dependent Distribution of Atopic Dermatitis in Primary Care: A Nationwide Population-based Study from Finland

Authors

  • Alexander Salava Department of Dermatology and Allergology, Helsinki University Hospital, Meilahdentie 2, FIN-00250 Helsinki, Finland
  • Ruut Rieppo Helsinki University Hospital, Department of Dermatology and Allergology
  • Antti Lauerma Helsinki University Hospital, Department of Dermatology and Allergology
  • Ville Salo

DOI:

https://doi.org/10.2340/actadv.v102.2287

Keywords:

Atopic dermatitis, age, primary care, population-based study

Abstract

The burden of atopic dermatitis (AD) appears to be increasing in adult and elderly patients. The aim of this study was to analyse the nationwide database of the Finnish Institute for Health and Welfare regarding the number of patients with AD and of general practitioner consultations in Finland during 2018. The database comprised the main diagnoses of all visits to public primary healthcare. There were 2,094,673 primary care patients (males/females 43.19/56.81%) and 20,905 patients with AD (1.00%) and 24,180 consultations due to AD (0.45%). The highest numbers of patients with AD were in the age groups 0–14 years (9,922 patients, 47.46%) and 15–65 years (9,144 patients, 43.74%). A substantial proportion of patients with AD were aged > 50 years (3,515 patients, 16.81%) or >65 years (1,947 patients, 9.31%). Regression analysis indicated a statistically significant association of age group with patient numbers (p = 0.032) and number of consultations (p = 0.030). There were no differences between direct age group comparisons (p = 0.303), sex (p = 0.389), or number of consultations/patient (p = 0.235). Patients with AD are prevalent in all age groups in Finnish primary care. Patient numbers were also relatively high in groups other than childhood, indicating that age-related distribution in primary care may be shifting to older ages.

Downloads

Download data is not yet available.

References

Weidinger S, Novak N. Atopic dermatitis. Lancet 2016; 387: 1109-1122.

https://doi.org/10.1016/S0140-6736(15)00149-X

Landis ET, Davis SA, Taheri A, Feldman SR. Top dermatologic diagnoses by age. Dermatol Online J 2014; 20: 22368.

https://doi.org/10.5070/D3204022368

Hadi HA, Tarmizi AI, Khalid KA, Gajdács M, Aslam A, Jamshed S. The epidemiology and global burden of atopic dermatitis: a narrative review. Life (Basel) 2021; 11: 936.

https://doi.org/10.3390/life11090936

Pols DHJ, Nielen MMJ, Korevaar JC, Bindels PJE, Bohnen AM. Reliably estimating prevalences of atopic children: an epidemiological study in an extensive and representative primary care database. NPJ Prim Care Respir Med 2017; 27: 23.

https://doi.org/10.1038/s41533-017-0025-y

Deo MS, Kerse N, Vandal AC, Jarret P. Dermatological disease in the older age group: a cross-sectional study in aged care facilities. BMJ Open 2015; 5: e009941.

https://doi.org/10.1136/bmjopen-2015-009941

Blume-Peytavi U, Kottner J, Sterry W, Hodin MW, Griffiths TW, Watson RE et al. Age-associated skin conditions and diseases: current perspectives and future options. Gerontologist 2016; 56: S230-S242.

https://doi.org/10.1093/geront/gnw003

Kiiski V, Salava A, Susitaival P, Barnhill S, Remitz A, Heliovaara M. Atopic dermatitis in adults: a population-based study in Finland. Int J Dermatol 2022; 61: 324-330.

https://doi.org/10.1111/ijd.15912

Chan LN, Magyari A, Ye M, Al-Alusi NA, Langan SM, Margolis D et al. The epidemiology of atopic dermatitis in older adults: a population-based study in the United Kingdom. PLoS One 2021; 16: e0258219.

https://doi.org/10.1371/journal.pone.0258219

Croce EA, Lopes FCPS, Ruth J. Interventions to improve primary care provider management of atopic dermatitis: a systematic review. Pediatr Dermatol 2021; 38: 1004-1011.

https://doi.org/10.1111/pde.14667

Benton EC, Kerr OA, Fisher A, Fraser SJ, McCormack SK, Tidman MJ. The changing face of dermatological practice: 25 years' experience. Br J Dermatol 2008; 159: 413-418.

https://doi.org/10.1111/j.1365-2133.2008.08701.x

Kerr OA, Tidman MJ, Walker JJ, Aldridge RD, Benton EC. The profile of dermatological problems in primary care. Clin Exp Dermatol 2010; 35: 380-383.

https://doi.org/10.1111/j.1365-2230.2009.03586.x

Database of the Finnish Institute for Health and Welfare (THL). Avohilmo: ICD-10. 2020. [accessed April 1, 2021]. Available from: https://sampo.thl.fi/pivot/prod/fi/avo/perus06/summary_icd1001.

Antti A, Salava A, Perälä M, Pelkonen AS, Mäkelä MJ, Remitz A. Are infants and toddlers with moderate-to-severe atopic dermatitis undertreated? Experiences of a Finnish Tertiary Care Hospital. Acta Derm Venereol 2021; 101: adv00368.

https://doi.org/10.2340/00015555-3739

World Bank Open Data; population of Finland 2018. [accessed April 1, 2021] Available from: https://data.worldbank.org/indicator/SP.POP.TOTL?locations=FI.

Al-Naqeeb J, Danner S, Fagnan LJ, Ramsey K, Michaels L, Mitchell J et al. The burden of childhood atopic dermatitis in the primary care setting: a report from the Meta-LARC consortium. J Am Board Fam Med 2019; 32: 191-200.

https://doi.org/10.3122/jabfm.2019.02.180225

Abuabara K, Magyari A, McCulloch CE, Linos E, Margolis DJ, Langan SM. Prevalence of atopic eczema among patients seen in primary care: data from the health improvement network. Ann Intern Med 2019; 170: 354-356.

https://doi.org/10.7326/M18-2246

de Lusignan S, Alexander H, Broderick C, Dennis J, McGovern A, Feeney C et al. Patterns and trends in eczema management in UK primary care (2009-2018): a population-based cohort study. Clin Exp Allergy 2021; 51: 483-494.

https://doi.org/10.1111/cea.13783

Fleming P, Yang YB, Lynde C, O'Neill B, Lee KO. Diagnosis and management of atopic dermatitis for primary care providers. J Am Board Fam Med 2020; 33: 626-635.

https://doi.org/10.3122/jabfm.2020.04.190449

Kim JP, Chao LX, Simpson EL, Silverberg JI. Persistence of atopic dermatitis (AD): a systematic review and meta-analysis. J Am Acad Dermatol 2016; 75: 681-687.e11.

https://doi.org/10.1016/j.jaad.2016.05.028

Lee HH, Patel KR, Singam V, Rastogi S, Silverberg JI. A systematic review and meta-analysis of the prevalence and phenotype of adult-onset atopic dermatitis. J Am Acad Dermatol 2019; 80: 1526-1532.e7.

https://doi.org/10.1016/j.jaad.2018.05.1241

Vakharia PP, Silverberg JI. Adult-onset atopic dermatitis: characteristics and management. Am J Clin Dermatol 2019; 20: 771-779.

https://doi.org/10.1007/s40257-019-00453-7

Mathiesen SM, Thomsen SF. The prevalence of atopic dermatitis in adults: systematic review on population studies. Dermatol Online J 2019; 25: 13030/qt6nj0x5k0.

https://doi.org/10.5070/D3258045124

Chiesa Fuxench ZC, Block JK, Boguniewicz M, Boyle J, Fonacier L, Gelfand JM. 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; 139: 583-590.

https://doi.org/10.1016/j.jid.2018.08.028

Hsu DY, Smith B, Silverberg JI. Atopic dermatitis and hospitalization for mental health disorders in the United States. Dermatitis 2019; 30: 54-61.

https://doi.org/10.1097/DER.0000000000000418

Mina S, Jabeen M, Singh S, Verma R. Gender differences in depression and anxiety among atopic dermatitis patients. Indian J Dermatol 2015; 60: 211.

Sandhu JK, Wu KK, Bui TL, Armstrong AW. Association between atopic dermatitis and suicidality: a systematic review and meta-analysis. JAMA Dermatol 2019; 155: 178-187.

https://doi.org/10.1001/jamadermatol.2018.4566

Amat F, Soria A, Tallon P, Bourgoin-Heck M, Lambert N, Deschildre A. New insights into the phenotypes of atopic dermatitis linked with allergies and asthma in children: an overview. Clin Exp Allergy 2018; 48: 919-934.

https://doi.org/10.1111/cea.13156

Dezoteux F, Astrid B, Chuffard M, Drumez E, Azib S, Staumont-Sallé D. Atopic dermatitis in elderly adults. Eur J Dermatol 2019; 29: 371-374.

https://doi.org/10.1684/ejd.2019.3609

Bylund S, Kobyletzki LB, Svalstedt M, Svensson Å. Prevalence and incidence of atopic dermatitis: a systematic review. Acta Derm Venereol 2020; 100: adv00160.

https://doi.org/10.2340/00015555-3510

Williamson S, Merritt J, De Benedetto A. Atopic dermatitis in the elderly: a review of clinical and pathophysiological hallmarks. Br J Dermatol 2020; 182: 47-54.

https://doi.org/10.1111/bjd.18652

Chan AR, Sandhu VK, Drucker AM, Fleming P, Lynde CW. Adult-onset atopic dermatitis: presentations and progress. J Cutan Med Surg 2020; 24: 267-272.

https://doi.org/10.1177/1203475420911896

Ersser SJ, Lattimer V, Surridge H, Brooke S. An analysis of the skin care patient mix attending a primary care-based nurse-led NHS walk-in centre. Br J Dermatol 2005; 153: 992-996.

https://doi.org/10.1111/j.1365-2133.2005.06863.x

Schofield JK, Fleming D, Grindlay D, Williams H. Skin conditions are the commonest new reason people present to general practitioners in England and Wales. Br J Dermatol 2011; 165: 1044-1050.

https://doi.org/10.1111/j.1365-2133.2011.10464.x

Salava A, Oker-Blom A, Remitz A. The spectrum of skin-related conditions in primary care during 2015-2019 - a Finnish nationwide database study. Skin Health Dis 2021; 1: e53.

https://doi.org/10.1002/ski2.53

Silverberg JI. Public health burden and epidemiology of atopic dermatitis. Dermatol Clin 2017; 35: 283-289.

https://doi.org/10.1016/j.det.2017.02.002

Downloads

Additional Files

Published

2022-06-15

How to Cite

Salava, A., Rieppo, R., Lauerma, A., & Salo, V. (2022). Age-dependent Distribution of Atopic Dermatitis in Primary Care: A Nationwide Population-based Study from Finland. Acta Dermato-Venereologica, 102, adv00738. https://doi.org/10.2340/actadv.v102.2287