Real-world comorbidities of atopic dermatitis in the pediatric ambulatory population in the United States

J Am Acad Dermatol. 2021 Oct;85(4):893-900. doi: 10.1016/j.jaad.2021.03.016. Epub 2021 Mar 6.


Background: Increasing evidence has suggested the systemic nature of atopic dermatitis (AD), a common inflammatory skin condition in children. However, comprehensive analyses of real-world comorbidities in pediatric AD are limited.

Objective: To characterize comorbidity burden in patients with AD aged <18 years old.

Methods: The MarketScan commercial claims database was queried from January 1, 2017, to December 31, 2017. Age- and sex-matched analyses were used to compare patients with AD with general population controls.

Results: A total of 86,969 pediatric patients with AD and 116,564 matched controls were identified. Increased anxiety (odds ratio [OR], 1.20) and attention-deficit hyperactivity disorder (OR, 1.11) were noted in patients with AD. In addition to dermatologic/allergic diseases, AD was also associated with infections, including methicillin-resistant Staphylococcus aureus (OR, 3.76), and autoimmune conditions, including vitiligo (OR, 2.98) and alopecia areata (OR, 4.32). Pediatric patients with AD had higher likelihoods of lymphoid/hematologic malignancies (OR, 1.94), ocular disorders (OR, 1.37-2.02), metabolic syndrome (OR, 1.61), and obesity (OR, 1.81). For all the ORs mentioned above, P was <.001.

Limitations: Retrospective analysis of health care claims data.

Conclusions: AD in pediatric patients was associated with a wide range of psychologic and systemic comorbidities. Increased awareness can help minimize its negative effects on the quality of life and prevent long-term health consequences in young patients with AD.

Keywords: MarketScan; atopic dermatitis; comorbidities; eczema; pediatric.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Comorbidity
  • Dermatitis, Atopic* / epidemiology
  • Eczema*
  • Humans
  • Methicillin-Resistant Staphylococcus aureus*
  • Quality of Life
  • Retrospective Studies
  • United States / epidemiology