Atopic dermatitis risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shalinder Singh, M.B.B.S.[2]

Overview

Atopic dermatitis is a multifactorial, chronic inflammatory skin disease as a result of interactions between various genetic, immune and environmental factors.

Risk Factors

The most potent risk factor in the development of atopic dermatitis is family history or personal history of atopy.

Common Risk Factors

Common risk factors in the development of atopic dermatitis include:
- Family history of atopic dermatitis or other atopy^[1]
  - 70% of atopic dermatitis patients have a positive family history of atopic diseases
  - Risk of developing atopic dermatitis is 2- to 3-fold higher in children with 1 atopic parent^[2]
  - Risk of developing atopic dermatitis is 3- to 5-fold higher in children with both atopic parents^[3]
- Loss of function mutations in the filaggrin (FLG) gene^[4]
  - Risk for earlier-onset atopic dermatitis
  - Risk for severe and persistent atopic dermatitis
- Personal history of atopy (asthma, allergic rhinitis, food allergy)^[5]

Less Common Risk Factors

Less common risk factors in the development of atopic dermatitis include:
- High domestic water calcium carbonate levels in infancy^[6]
- Higher level of parental education^[7]
- Living in urban areas^[8]
- Exposure to antibiotics in infancy^[9]
- Colder climates with low humidity
- Active and passive exposure to tobacco^[10]

References

↑ Wen HJ, Chen PC, Chiang TL, Lin SJ, Chuang YL, Guo YL (November 2009). "Predicting risk for early infantile atopic dermatitis by hereditary and environmental factors". Br. J. Dermatol. 161 (5): 1166–72. doi:10.1111/j.1365-2133.2009.09412.x. PMID 19785611.
↑ Küster W, Petersen M, Christophers E, Goos M, Sterry W (1990). "A family study of atopic dermatitis. Clinical and genetic characteristics of 188 patients and 2,151 family members". Arch. Dermatol. Res. 282 (2): 98–102. PMID 2353830.
↑ Küster W, Petersen M, Christophers E, Goos M, Sterry W (1990). "A family study of atopic dermatitis. Clinical and genetic characteristics of 188 patients and 2,151 family members". Arch. Dermatol. Res. 282 (2): 98–102. PMID 2353830.
↑ Palmer CN, Irvine AD, Terron-Kwiatkowski A, Zhao Y, Liao H, Lee SP, Goudie DR, Sandilands A, Campbell LE, Smith FJ, O'Regan GM, Watson RM, Cecil JE, Bale SJ, Compton JG, DiGiovanna JJ, Fleckman P, Lewis-Jones S, Arseculeratne G, Sergeant A, Munro CS, El Houate B, McElreavey K, Halkjaer LB, Bisgaard H, Mukhopadhyay S, McLean WH (April 2006). "Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis". Nat. Genet. 38 (4): 441–6. doi:10.1038/ng1767. PMID 16550169.
↑ Suh KY (June 2010). "Food allergy and atopic dermatitis: separating fact from fiction". Semin Cutan Med Surg. 29 (2): 72–8. doi:10.1016/j.sder.2010.03.007. PMID 20579595.
↑ Perkin MR, Craven J, Logan K, Strachan D, Marrs T, Radulovic S, Campbell LE, MacCallum SF, McLean WH, Lack G, Flohr C (August 2016). "Association between domestic water hardness, chlorine, and atopic dermatitis risk in early life: A population-based cross-sectional study". J. Allergy Clin. Immunol. 138 (2): 509–16. doi:10.1016/j.jaci.2016.03.031. PMID 27241890.
↑ Weber AS, Haidinger G (November 2010). "The prevalence of atopic dermatitis in children is influenced by their parents' education: results of two cross-sectional studies conducted in Upper Austria". Pediatr Allergy Immunol. 21 (7): 1028–35. doi:10.1111/j.1399-3038.2010.01030.x. PMID 20444159.
↑ Schram ME, Tedja AM, Spijker R, Bos JD, Williams HC, Spuls PI (May 2010). "Is there a rural/urban gradient in the prevalence of eczema? A systematic review". Br. J. Dermatol. 162 (5): 964–73. doi:10.1111/j.1365-2133.2010.09689.x. PMID 20331459.
↑ Tsakok T, McKeever TM, Yeo L, Flohr C (November 2013). "Does early life exposure to antibiotics increase the risk of eczema? A systematic review". Br. J. Dermatol. 169 (5): 983–91. doi:10.1111/bjd.12476. PMID 23782060.
↑ Kantor R, Kim A, Thyssen JP, Silverberg JI (December 2016). "Association of atopic dermatitis with smoking: A systematic review and meta-analysis". J. Am. Acad. Dermatol. 75 (6): 1119–1125.e1. doi:10.1016/j.jaad.2016.07.017. PMC 5216172. PMID 27542586.

Template:WikiDoc Sources

[pmid19785611-1] Wen HJ, Chen PC, Chiang TL, Lin SJ, Chuang YL, Guo YL (November 2009). "Predicting risk for early infantile atopic dermatitis by hereditary and environmental factors". Br. J. Dermatol. 161 (5): 1166–72. doi:10.1111/j.1365-2133.2009.09412.x. PMID 19785611.

[pmid2353830-2] Küster W, Petersen M, Christophers E, Goos M, Sterry W (1990). "A family study of atopic dermatitis. Clinical and genetic characteristics of 188 patients and 2,151 family members". Arch. Dermatol. Res. 282 (2): 98–102. PMID 2353830.

[pmid23538302-3] Küster W, Petersen M, Christophers E, Goos M, Sterry W (1990). "A family study of atopic dermatitis. Clinical and genetic characteristics of 188 patients and 2,151 family members". Arch. Dermatol. Res. 282 (2): 98–102. PMID 2353830.

[pmid16550169-4] Palmer CN, Irvine AD, Terron-Kwiatkowski A, Zhao Y, Liao H, Lee SP, Goudie DR, Sandilands A, Campbell LE, Smith FJ, O'Regan GM, Watson RM, Cecil JE, Bale SJ, Compton JG, DiGiovanna JJ, Fleckman P, Lewis-Jones S, Arseculeratne G, Sergeant A, Munro CS, El Houate B, McElreavey K, Halkjaer LB, Bisgaard H, Mukhopadhyay S, McLean WH (April 2006). "Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis". Nat. Genet. 38 (4): 441–6. doi:10.1038/ng1767. PMID 16550169.

[pmid20579595-5] Suh KY (June 2010). "Food allergy and atopic dermatitis: separating fact from fiction". Semin Cutan Med Surg. 29 (2): 72–8. doi:10.1016/j.sder.2010.03.007. PMID 20579595.

[pmid27241890-6] Perkin MR, Craven J, Logan K, Strachan D, Marrs T, Radulovic S, Campbell LE, MacCallum SF, McLean WH, Lack G, Flohr C (August 2016). "Association between domestic water hardness, chlorine, and atopic dermatitis risk in early life: A population-based cross-sectional study". J. Allergy Clin. Immunol. 138 (2): 509–16. doi:10.1016/j.jaci.2016.03.031. PMID 27241890.

[pmid20444159-7] Weber AS, Haidinger G (November 2010). "The prevalence of atopic dermatitis in children is influenced by their parents' education: results of two cross-sectional studies conducted in Upper Austria". Pediatr Allergy Immunol. 21 (7): 1028–35. doi:10.1111/j.1399-3038.2010.01030.x. PMID 20444159.

[pmid20331459-8] Schram ME, Tedja AM, Spijker R, Bos JD, Williams HC, Spuls PI (May 2010). "Is there a rural/urban gradient in the prevalence of eczema? A systematic review". Br. J. Dermatol. 162 (5): 964–73. doi:10.1111/j.1365-2133.2010.09689.x. PMID 20331459.

[pmid23782060-9] Tsakok T, McKeever TM, Yeo L, Flohr C (November 2013). "Does early life exposure to antibiotics increase the risk of eczema? A systematic review". Br. J. Dermatol. 169 (5): 983–91. doi:10.1111/bjd.12476. PMID 23782060.

[pmid27542586-10] Kantor R, Kim A, Thyssen JP, Silverberg JI (December 2016). "Association of atopic dermatitis with smoking: A systematic review and meta-analysis". J. Am. Acad. Dermatol. 75 (6): 1119–1125.e1. doi:10.1016/j.jaad.2016.07.017. PMC 5216172. PMID 27542586.

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