On the question of the validity of epidemiological data regarding atopic dermatitis

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Abstract

Atopic dermatitis is a heterogeneous disease. Its development is associated with certain genes, features of immune mechanisms, dysfunction of the skin barrier, and the influence of several environmental factors. As recent studies show, clinical symptoms depend on the age of the patient, disease severity, response to therapy, and molecular mechanisms involved (endotypes of atopic dermatitis). The features of atopic dermatitis were revealed depending on the race and/or ethnicity of the patients. In addition, the phenotype and endotype of the disease should be taken into account when making a diagnosis of atopic dermatitis.

Atopic dermatitis is diagnosed clinically, based on the data of the anamnesis of the disease and a doctor’s examination. Due to the variability of clinical manifestations, skin lesions and wave-like course, it is even more difficult to correctly diagnose the disease in population studies. Even if the results are obtained on carefully selected groups in specialized clinics and in cross-sectional studies, they may be subject to systematic error and limited generalizability.

All of the aforementioned strongly influence the epidemiological data regarding atopic dermatitis. Today, the prevalence rates of atopic dermatitis vary widely around the world. Epidemiological data are primarily affected by such factors as the lack of a unified approach to the definition of atopic dermatitis, design and methods of studies, disease codes, and diagnosis. In addition, it is important how accurately the diagnosis is made and what the severity of atopic dermatitis is. Entries in electronic records, including written prescriptions, also do not contribute to a sufficiently accurate identification of such patients. It is necessary to clarify the clinical diagnosis of atopic dermatitis and disease codes, including those misdiagnosed as atopic dermatitis, which directly affects the epidemiological data on atopic dermatitis in general.

Thus, the epidemiology of atopic dermatitis is insufficiently studied and requires a unified approach. To fully understand the true prevalence of this disease, further research is needed, as well as updating the classification of allergic diseases.

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About the authors

Dali Sh. Macharadze

Peoples' Friendship University of Russia

Author for correspondence.
Email: dalim_a@mail.ru
ORCID iD: 0000-0001-5999-7085
SPIN-code: 2399-5783

MD, Dr. Sci (Med.)

Russian Federation, Moscow

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