Atopic Dermatitis

Atopic dermatitis, also known as atopic eczema or eczema, is one of the most common chronic inflammatory skin conditions, affecting people of all ages and genders around the world.1,2 It appears as a rash (or skin lesions), causes itching, and may worsen or flare over time.3 More than “just a rash,” atopic dermatitis can be a potentially debilitating condition that disrupts patients’ daily lives and can negatively impact their emotional well-being.4,5 Specifically, atopic dermatitis can lead to disturbed sleep, embarrassment, and difficulty concentrating, among other things.5  Atopic dermatitis can be classified as mild, moderate, or severe depending on several factors, including the extent and severity of disease.2

While there is no cure for atopic dermatitis, there are treatments available.1 Current treatment options aim to provide improvements in rash and symptom burden, including itch relief, the hallmark symptom of the disease.1,6 However, significant unmet needs remain, and the community is in need of new long-term treatment options for this chronic disease that are both safe and effective.7

At Pfizer, patients are at the center of everything we do. Our work aims to enable freedom from the day-to-day suffering of people living with chronic inflammatory diseases like atopic dermatitis. View the resources below to learn more about atopic dermatitis and our efforts to support people living with this condition.

Disease Education Information

Who Gets Atopic Dermatitis?

As one of the most common, chronic, relapsing inflammatory skin conditions, atopic dermatitis affects hundreds of millions of people worldwide, including up to approximately 10% of adults and approximately 20% of children.1,8 Approximately 1 in 3 people with atopic dermatitis have moderate-to-severe disease.2,9

Atopic dermatitis is thought to have more than one cause, including genetic factors, and is more likely to develop in people whose parents have asthma, hay fever, or atopic dermatitis.1

While atopic dermatitis can affect people of all ages and genders around the world, not all groups are affected in the same way.1,2,10 For example, in one study, children and adults who were hospitalized for atopic dermatitis were more likely to be nonwhite as opposed to white.11

What Are the Symptoms of Atopic Dermatitis?

Common symptoms of atopic dermatitis include 1:

  • Itch (pruritus)
  • Red/pink or discolored skin patches
  • Thick, hard, “leathery” patches
  • Dry or bumpy skin rash
  • Open, crusted, or “weepy-looking” blisters or sores

The hallmark symptom of atopic dermatitis is a burdensome itch, which 91% of 304 patients reported happening at least once per day in one questionnaire.6,12 This itching can be disabling because patients with atopic dermatitis often don’t sleep well, which can leave them feeling exhausted and is a predictor of poor health.13

In addition to the physical burden, atopic dermatitis can have a serious impact on a person’s mental well-being, leaving patients feeling embarrassed, depressed, unhappy, or with diminished self-confidence.5 For example, one study showed that 43% of 2,002 patients with moderate-to-severe disease experienced concern about being seen in public during a flare.5 Further, over half of patients with moderate-to-severe atopic dermatitis in this same study suggested they felt depressed at times.5 People living with atopic dermatitis should be sure to discuss these often “unseen” impacts of their disease with their doctors too.

Living with atopic dermatitis can also impact patients’ lifestyles.5 For example, many patients avoid certain activities while they are experiencing flares, such as swimming, bathing, or wearing certain clothes.5 In the aforementioned study, patients with moderate-to-severe atopic dermatitis also reported missing 2.5 days of school or work each year because of their condition.5 The impact on caregivers, such as a parent, can be significant as well, with some spending two to three hours a day managing their child’s atopic dermatitis.14

How Is Atopic Dermatitis Diagnosed?

Atopic dermatitis is often diagnosed by doctors examining patients’ skin as well as a review of their relevant medical history.15 Typically, no lab testing is required to diagnose atopic dermatitis.16 Essential diagnostic features of atopic dermatitis include itch and the location and appearance of a rash.15 Other important diagnostic features include personal or family history of hay fever, asthma, or atopic dermatitis, age of onset, and dry skin.15

It is important to keep track of any changing signs on the skin in between doctor visits, such as a rash, and also discuss “unseen” impacts with a doctor. For those seeing a general practitioner, or family physician, who haven’t gotten relief from their atopic dermatitis, it may be time to ask for a referral to a medical dermatologist.

How Is Atopic Dermatitis Treated?

While there is no cure for atopic dermatitis, there are multiple treatment options available depending on disease severity.1 These include 1:

  • Topical therapies, which are applied directly to one’s skin like a cream or ointment
  • Systemic therapies, which may be taken as pills or injections that affect the body’s immune system

Patients should discuss available treatment options and create a treatment plan with their doctor.

There is a critical need for additional innovative therapeutic options for patients living with atopic dermatitis for whom current treatment options are not enough.

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References:
 

1. Weidinger S, Beck LA, Bieber T, Kabashima K, Irvine AD. Atopic dermatitis. Nat Rev Dis Primers. 2018;4:1. doi.org/10.1038/s41572-018-0001-z.

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

3. Anderson RT, Rajagopalan R. Effects of allergic dermatosis on health-related quality of life. Curr Allergy Asthma Rep. 2001;1:309-315.

4. Na CH, Chung J, Simpson EL. Quality of life and disease impact of atopic dermatitis and psoriasis on children and their families. Children (Basel). 2019;6:133. doi:10.3390/children6120133.

5. Zuberbier T, Orlow SJ, Paller AS, et al. Patient perspectives on the management of atopic dermatitis. J Allergy Clin Immunol. 2006;118(1):226-232.

6. Wahlgren CF. (1999), Itch and atopic dermatitis: an overview. J Dermatol. 1999:26:770-779.

7. Simpson E, Udkoff J, Borok J, Tom W, Beck L, Eichenfield LF. Atopic dermatitis: emerging therapies. Semin Cutan Med Surg. 2017;36(3): 124-130. doi:10.12788/j.sder.2017.0137.

8. Nutten S. Atopic dermatitis: global epidemiology and risk factors. Ann Nutr Metab. 2015;66(suppl 1):8-16.

9. Chiesa Fuxench ZC, Block JK, Boguniewicz M, et al. 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(3):583-590.

10. Brunner PM, Guttman-Yassky E. Racial differences in atopic dermatitis. Ann Allergy Asthma Immunol. 2019;122:449-455. doi:10.1016/j.anai.2018.11.015.

11. Narla S, Hsu DY, Thyssen JP, Silverberg JI. Predictors of hospitalization, length of stay, and costs of care among adult and pediatric inpatients with atopic dermatitis in the United States. Dermatitis. 2018;29(1):22-31.

12. Dawn A, Papoiu ADP, Chan YH, Rapp SR, Rassette N, Yosipovitch G. Itch characteristics in atopic dermatitis: results of a web-based questionnaire. Br J Dermatol. 2009;160:642-644. doi:10.1111/j.1365-2133.2008.08941.

13. Silverberg JI, Garg NK, Paller AS, Fishbein AB, Zee PC. Sleep disturbances in adults with eczema are associated with impaired overall health: a US population-based study. J Invest Dermatol. 2015;135:56-66. doi:10.1038/jid.2014.325.

14. Su JC, Kemp AS, Varigos GA, Nolan TM. Atopic eczema: its impact on the family and financial cost. Arch Dis Child. 1997;76:159-162.

15. Eichenfield LF, Tom WL, Chamlin SL, et al. Guidelines of care for the management of atopic dermatitis: section 1 - diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol. 2014;70:338-351.

16. Siegfried EC, Hebert AA. Diagnosis of atopic dermatitis: mimics, overlaps, and complications. J Clin Med. 2015;4(5):884-917. doi:10.3390/jcm4050884.