Atopic dermatitis may be more prevalent, severe in patients with skin of color

Atopic dermatitis may be more prevalent and more severe in patients with skin of color, according to findings published in the Journal of Drugs in Dermatology.

“Research on the role of race and ethnicity in the pathophysiology of atopic dermatitis (AD) is limited,” Andrew F. Alexis, MD, MPH, FAAD, of Weill Cornell Medical College, and colleagues wrote.

They noted variability in epidemiology, clinical presentation and disease course exists in the literature for patients with skin of color with AD.

The aim of the literature review was to provide insight on distinct features of AD found in patients with skin of color. In addition, Alexis and colleagues offered recommendations for skincare interventions and best practices to treat AD in various patient population groups with different skin color types.

Recommendations for gentle cleansers and moisturizers also were explored.

Results showed that different racial and ethnic groups have different skin barrier properties that may be impacted by AD. This, in turn, could impact barrier function.

The morphology, severity and distribution of AD at presentation has also been reported in non-white patient populations, according to the findings.

Patients who self-identified as Black or African American may have higher prevalence rates of AD. Similarly, health care utilization for AD was observed in this population and in those who self-identified as Asian or Pacific Islanders.

A number of pigmentary sequalae were observed in patients with skin of color who had AD, including hyper-, hypo- and depigmentation. The researchers suggested that this could impact quality of life parameters for these patients.

Melanin-rich skin may make xerosis more visible and drier, leading to stigma and quality of life concerns for these patients. Pruritis may also be higher in these populations, which the researchers suggested could be associated with AD.

Proactive treatment and maintenance are recommended for these patients to control inflammation longitudinally. Both effective skin barrier strategies and culturally competent care should be considered.

“Robust comparative studies are needed to better understand racial/ethnic variations in AD,” Alexis and colleagues concluded. “Further research will help to tailor patient education and foster individualized approaches to treatment, prevention and adjunctive skin care across the diverse spectrum of patient populations.”