Research ArticleOriginal Research
The Burden of Childhood Atopic Dermatitis in the Primary Care Setting: A Report from the Meta-LARC Consortium
Jinan Al-naqeeb, Sankirtana Danner, Lyle J. Fagnan, Katrina Ramsey, LeAnn Michaels, Julie Mitchell, Kelsey Branca, Cynthia Morris, Donald E. Nease, Linda Zittleman, Barcey Levy, Jeanette Daly, David Hahn, Rowena J. Dolor, Hywel C. Williams, Joanne R. Chalmers, Jon Hanifin, Susan Tofte, Katharine E. Zuckerman, Karen Hansis, Mollie Gundersen, Julie Block, Francie Karr, Sandra Dunbrasky, Kathy Siebe, Kristen Dillon, Ricardo Cibotti, Jodi Lapidus and Eric L. Simpson
The Journal of the American Board of Family
Medicine March 2019, 32 (2) 191-200; DOI: https://doi.org/10.3122/jabfm.2019.02.180225
Jinan Al-naqeeb
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Sankirtana Danner
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Lyle J. Fagnan
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Katrina Ramsey
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
LeAnn Michaels
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Julie Mitchell
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Kelsey Branca
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Cynthia Morris
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Donald E. Nease Jr.
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Linda Zittleman
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Barcey Levy
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Jeanette Daly
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
David Hahn
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Rowena J. Dolor
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Hywel C. Williams
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Joanne R. Chalmers
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Jon Hanifin
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Susan Tofte
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Katharine E. Zuckerman
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Karen Hansis
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Mollie Gundersen
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Julie Block
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Francie Karr
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Sandra Dunbrasky
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Kathy Siebe
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Kristen Dillon
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Ricardo Cibotti
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Jodi Lapidus
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Eric L. Simpson
Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
Abstract
Background: Little is known about the burden of atopic dermatitis (AD) encountered in US primary care practices and the frequency and type of skin care practices routinely used in children.
Objective: To estimate the prevalence of AD in children 0 to 5 years attending primary care practices in the United States and to describe routine skin care practices used in this population.
Design: A cross-sectional survey study of a convenience sample of children under the age of 5 attending primary care practices for any reason.
Setting: Ten primary care practices in 5 US states.
Results: Among 652 children attending primary care practices, the estimated prevalence of ever having AD was 24% (95% CI, 21–28) ranging from 15% among those under the age of 1 to 38% among those aged 4 to 5 years. The prevalence of comorbid asthma was higher among AD participants compared to those with no AD, namely, 12% and 4%, respectively (P < .001). Moisturizers with high water:oil ratios were most commonly used (ie, lotions) in the non-AD population, whereas moisturizers with low water:oil content (ie, ointments) were most common when AD was present.
Conclusions: Our study found a large burden of AD in the primary care practice setting in the US. The majority of households reported skin care practices that may be detrimental to the skin barrier, such as frequent bathing and the routine use of moisturizers with high water: oil ratios. Clinical trials are needed to identify which skin care practices are optimal for reducing the significant burden of AD in the community.
In this issue
The Burden of Childhood Atopic Dermatitis in the Primary Care Setting: A Report from the Meta-LARC Consortium
Jinan Al-naqeeb, Sankirtana Danner, Lyle J. Fagnan, Katrina Ramsey, LeAnn Michaels, Julie Mitchell, Kelsey Branca, Cynthia Morris, Donald E. Nease, Linda Zittleman, Barcey Levy, Jeanette Daly, David Hahn, Rowena J. Dolor, Hywel C. Williams, Joanne R. Chalmers, Jon Hanifin, Susan Tofte, Katharine E. Zuckerman, Karen Hansis, Mollie Gundersen, Julie Block, Francie Karr, Sandra Dunbrasky, Kathy Siebe, Kristen Dillon, Ricardo Cibotti, Jodi Lapidus, Eric L. Simpson
The Journal of the American Board of Family
Medicine Mar 2019, 32 (2) 191-200; DOI: 10.3122/jabfm.2019.02.180225
The Burden of Childhood Atopic Dermatitis in the Primary Care Setting: A Report from the Meta-LARC Consortium
Jinan Al-naqeeb, Sankirtana Danner, Lyle J. Fagnan, Katrina Ramsey, LeAnn Michaels, Julie Mitchell, Kelsey Branca, Cynthia Morris, Donald E. Nease, Linda Zittleman, Barcey Levy, Jeanette Daly, David Hahn, Rowena J. Dolor, Hywel C. Williams, Joanne R. Chalmers, Jon Hanifin, Susan Tofte, Katharine E. Zuckerman, Karen Hansis, Mollie Gundersen, Julie Block, Francie Karr, Sandra Dunbrasky, Kathy Siebe, Kristen Dillon, Ricardo Cibotti, Jodi Lapidus, Eric L. Simpson
The Journal of the American Board of Family
Medicine Mar 2019, 32 (2) 191-200; DOI: 10.3122/jabfm.2019.02.180225
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