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Eczema more common in older adults than initially thought

The prevalence of active atopic eczema is high among older adults and increases with age, according to research published in Annals of Internal Medicine.

“Atopic eczema was traditionally considered to remit in most children by adolescence,” Katrina Abuabara, MD, MA, MSCE, assistant professor in the department of dermatology at the University of California, San Francisco, and colleagues wrote. “However, increasing genetic and epidemiologic evidence suggests that it is an episodic, inflammatory disorder that can occur throughout life. ... Relatively little is known about physician-diagnosed adult disease.”

Between 1994 and 2013, Abuabara and colleagues analyzed data from The Health Improvement Network to determine the lifetime prevalence of active atopic eczema among primary care patients aged 0 to 99 years (n = 8,604,333).

Atopic eczema was identified using a validated algorithm. During each follow-up year, the researchers measured the prevalence of active eczema that required a visit to a physician or prescription. The number and types of prescriptions, as well as the rates of asthma and rhinitis/seasonal allergies by age were documented.

Overall, the prevalence of atopic eczema across a lifetime was 9.9%. Active disease was most common among children and older adults. A median of six medications were prescribed to patients each year, including topical steroids and systemic treatments. All ages received a similar number of annual prescriptions.

Sensitivity analyses that defined active eczema based on prescription only and excluded patients with similar or overlapping conditions, such as contact dermatitis and psoriasis, showed similar results.

“As new targeted therapies become available, primary care providers will probably play a larger role in managing adults with atopic eczema,” Abuabara and colleagues concluded. “Attention should be paid to clinical testing in older adults, who may require special considerations for pharmacology, polypharmacy and multimorbidity.” – by Alaina Tedesco

Disclosures: Abuabara reports receiving grants from Dermatology Foundation, NIH and Robert Wood Johnson Foundation, as well as personal fees from TARGETPharma. Please see study for all other authors’ relevant financial disclosures.