Disease Trajectories in Childhood Atopic Dermatitis

An Update and Practitioner's Guide

A.D. Irvine; P. Mina-Osorio


The British Journal of Dermatology. 2019;181(5):895-906. 

In This Article


This is a narrative review that synthesizes and simplifies the epidemiological data from various large cohort studies (Figure S1; see Supporting Information). This review will help to identify a common pattern among childhood AD characteristics (subphenotypes) and to increase awareness about the complexity of AD among clinicians, as well as the multiple potential trajectories of AD progression. Studies were selected based on the following criteria: (i) cohorts with sample sizes larger than 500 patients; (ii) studies focusing on the patient population of interest (paediatric patients with AD; cohorts studying paediatric patients with asthma or allergic rhinitis were mostly excluded, even if some AD-related outcomes were included – with the exception of a few insightful studies); (iii) longitudinal studies or long-term studies with more than one cross-sectional data analysis to determine development of comorbidities or persistence over time and (iv) studies focusing on key questions such as influence of environmental factors or parental history of atopy on the risk of development of comorbid conditions. We complement this information by providing a practitioner's guide with some representative clinical scenarios for identifying infants and children with AD who are at risk of disease progression and developing atopic comorbidities.