The Burden of Childhood Atopic Dermatitis in the Primary Care Setting: A Report from the Meta-LARC Consortium

Article Figures & Data

Table 1.

Population Characteristics by Atopic Dermatitis Status

Characteristic	Overall	AD	No AD	P value^*
Characteristic	No. (%)	No. (%)	No. (%)	P value^*
N	652 (100)	159 (100)	493 (100)
Child age (years)				<.001
<1	240 (37)	35 (22)	205 (42)
1	165 (25)	39 (25)	126 (26)
2	75 (12)	21 (13)	54 (11)
3	55 (8)	19 (12)	36 (7)
4	65 (10)	26 (16)	39 (8)
5^†	52 (8)	19 (12)	33 (7)
Child sex: Female	321 (50)	73 (46)	248 (51)	.35
Caregiver responded in Spanish	32 (5)	8 (5)	24 (5)	.93
Race/ethnicity				.53
Hispanic, any race	140 (21)	30 (19)	110 (22)
White non-Hispanic	367 (56)	91 (57)	276 (56)
Black non-Hispanic	75 (12)	24 (15)	51 (10)
Asian non-Hispanic	11 (2)	2 (1)	9 (2)
More than one race	34 (5)	6 (4)	28 (6)
Prefer not to say	25 (4)	6 (4)	19 (4)
Generally dry skin	181 (28)	99 (63)	82 (17)	<.001
State				0.25
Oregon	212 (33)	46 (29)	166 (34)
Wisconsin	78 (12)	21 (13)	57 (12)
Iowa	93 (14)	29 (18)	64 (13)
Colorado	56 (9)	17 (11)	39 (8)
North Carolina	213 (33)	46 (29)	167 (34)

Table 2.

Atopic Dermatitis Prevalence and Severity and Medication Prescribed, by Age^*

	N	% Prevalence of AD^† (95% CI)	Among children with AD:
Age Category	N	% Prevalence of AD^† (95% CI)	N	Moderate/severe^‡ AD Percent (95% CI)	Sleep disturbed in past week Percent (95% CI)	Medication prescribed Percent (95% CI)
Overall	652	24 (21–28)	159	42 (36–47)	21 (15–27)	75 (68–82)
Child age <1 year	240	15 (12–17)	35	48 (37–60)	24 (11–37)	67 (54–79)
1 year	165	24 (19–29)	39	29 (13–44)	15 (5–24)	69 (56–82)
2 to 3 Years	130	31 (22–40)	40	41 (28–53)	22 (6–39)	75 (60–90)
4 to 5^§ Years	117	38 (29–48)	45	49 (31–66)	22 (14–31)	86 (76–97)
p value		<.001		.094	.69	.019

AD, atopic dermatitis; CI, confidential interval.
↵* Percents are mean predictions from a logistic model with clustered standard errors to account for correlation between children from the same clinic. P values are from likelihood ratio χ² test.
† Represents ever history of AD.
↵‡ <3% reported severe rash overall.
↵§ Includes children age 6 years, 0 months.

Table 3.

History of Atopy and Allergic Comorbidities by Atopic Dermatitis Status^*

Comorbidity	Overall (n = 652)		AD (n = 159)		No AD (n = 493)		Age-Adjusted Prevalence Ratio		P value
Comorbidity	%	95% CI	%	95% CI	%	95% CI	PR^a	95% CI	P value
Asthma	7	(5–8)	12	(9–16)	4	(3–6)	3.0	(1.8–4.9)	<.001
Wheezing without cold	6	(4–9)	9	(6–13)	5	(3–8)	1.8	(1.1–2.7)	.011
Wheezing (ever)	21	(18–23)	26	(19–33)	19	(16–22)	1.4	(1.02–1.9)	.038
Food allergy	4	(3–5)	8	(4–12)	2	(1–3)	3.7	(1.5–9.2)	.005
Family history of atopic condition	69	(63–75)	82	(74–90)	65	(59–71)	1.3	(1.2–1.4)	<.001
Parent with asthma	31	(25–37)	36	(28–44)	29	(24–35)	1.2	(1.01–1.5)	.037

AD, atopic dermatitis; CI, confidential interval; PR, prevalence ratio.
↵* Percents are marginal predictions and prevalence ratio is the exponentiated coefficient from a log-binomial (relative risk) model for the comorbidity including AD and age (months) as predictors. P values are from the Wald test for AD vs no AD.

Table 4.

Skin Care Practices by Atopic Dermatitis Status^*

Skin Care Practice	Overall		AD		No AD		P value
Skin Care Practice	%	(95% CI)	%	(95% CI)	%	(95% CI)	P value
N	652		159		493
Any current moisturizer use (%)	78	(71–84)	90	(84–96)	74	(66–82)	<.001
Among current moisturizer users (N)	500		144		356
Where moisturizer applied
All over body	91	(88–94)	88	(81–94)	93	(90–95)	.30
Just to dry, flaky, or red spots	9	(6–12)	13	(6–19)	7	(5–10)
Type of moisturizer(s) used^†
Lotion	54	(47–61)	29	(18–40)	64	(58–70)	<.001
Ointment	28	(20–35)	41	(33–49)	22	(13–31)	<.001
Cream	14	(8–19)	24	(17–32)	9	(4–14)	<.001
Liquid Oil	4	(3–6)	7	(3–11)	3	(2–5)	.05
Unspecified lotion or cream	32	(28–36)	38	(29–47)	29	(25–33)	.022

AD, atopic dermatitis; CI, confidential interval.
↵* Percents are mean predictions from a logistic model with age (months) and clustered standard errors to account for correlation between babies from the same clinic. P values are from Wald test for AD vs no AD adjusted for age.
↵† Multiple answers possible to type of moisturizer.

Table 5.

Proportions of patients reporting frequent (>4 days per week) bathing and moisturizer by age and Atopic Dermatitis Status^*

Child age	Overall			AD			No AD
Child age	N	%^†	(95% CI)	N	%^†	(95% CI)	N	%^†	(95% CI)
Frequent bathing (≥4 days per week)
<1	224	45	(36–53)	33	36	(15–58)	191	46	(39–53)
1	158	70	(63–78)	38	63	(52–74)	120	72	(64–81)
2 to 3	124	69	(57–82)	37	68	(43–92)	87	70	(58–82)
4 to 5^‡	111	63	(51–76)	44	61	(41–82)	67	64	(47–81)
Total	617	59	(52–67)	152	58	(47–69)	465	60	(52–68)
Frequent moisturizer use^‡ (≥4 days per week)
<1	173	60	(53–67)	30	77	(67–87)	143	57	(50–64)
1	132	71	(62–67)	35	74	(67–82)	97	70	(59–81)
2 to 3	95	69	(57–82)	33	79	(70–88)	62	65	(45–84)
4 to 5^§	77	61	(47–75)	41	71	(60–82)	36	50	(31–69)
Total	477	65	(57–73)	139	75	(69–81)	338	61	(52–70)

AD, atopic dermatitis; CI, confidential interval.
↵* Percents are mean predictions from a logistic model with clustered standard errors to account for correlation between babies from the same clinic.
↵† Total N (denominator) for given age/AD group.
↵‡ The denominator for moisturizers frequency includes only those who reported using moisturizers on their child skin.
↵§ Includes children aged 6 years, 0 months.