From the dermatology foundationA systematic review and meta-analysis of the prevalence and phenotype of adult-onset atopic dermatitis
Section snippets
Literature search
The following databases were searched for articles up to December 1, 2017: Cochrane Library, Medline (PubMed and Ovid), Embase, GREAT (Global Resource of EczemA Trials), LILACS (Latin American and Caribbean Health Sciences Literature) and Scopus. The search strategy was modified from a previous Cochrane review of AD10 to also include a number of search terms related to age of disease onset (Supplemental Table I; available at http://www.jaad.org).11, 12, 13
Any cross-sectional or cohort study was
Literature search
Overall, 4074 nonduplicate citations were identified in the database search; 3690 were excluded during title and abstract review and 359 during full-text review. In total, 25 observational studies met inclusion and exclusion criteria and were included in this systematic review (Fig 1).14
Study characteristics
The 25 observational studies were published during 1956-2017.5, 11, 12, 13, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35 Six (24%) studies had prospective cohorts, 4 (16%)
Discussion
The results of this systematic review and meta-analysis of observational studies suggest that ∼1 in 4 adults with AD report adult-onset disease, with relatively consistent proportions of adult-onset disease for both sexes across different regions. There were several important characteristics that seemed to differ between adult-onset and child-onset AD, including higher proportions of foot dermatitis and lower proportions of flexural eczema and multiple other signs and symptoms.
Some have
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Funding sources: Supported by the Agency for Healthcare Research and Quality (grant no. K12 HS023011) and the Dermatology Foundation.
Conflicts of interest: None disclosed.
Reprints not available from the authors.