In the opinion of Raj Chovatiya, MD, PhD, the longitudinal course of atopic dermatitis (AD) is an important yet overlooked clinical domain of the disease.
Dr Raj Chovatiya
"We know that AD is associated with fluctuating severity, disease flares, long-term persistence, and periods of quiescence, but its longitudinal course is not routinely incorporated into guidelines or clinical trials," Chovatiya, assistant professor in the department of dermatology at Northwestern University, Chicago, said during the Revolutionizing Atopic Dermatitis virtual symposium. "Understanding the long-term course may improve our ability to phenotype, prognosticate, and personalize our care."
The classic view of AD is that it starts in early childhood, follows a waxing and waning course for a few years, and burns out by adulthood. "I think we all know that this is generally false," he said. "This was largely based on anecdotal clinical experience and large cross-sectional studies, not ones that consider the heterogeneity of AD."
Results from a large-scale, prospective study of 7,157 children enrolled in the Pediatric Eczema Elective Registry (PEER), suggests that AD commonly persists beyond adulthood. PEER was a phase IV postmarketing safety study of children aged 12-17 with moderate to severe AD who were exposed to topical pimecrolimusand who were surveyed every 6 months (
