REVIEW   Free access

Italian Journal of Dermatology and Venereology 2021 December;156(6):650-8

DOI: 10.23736/S2784-8671.20.06669-9

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Atopic dermatitis in schoolchildren and adolescents: a critical review of Italian epidemiological data and systemic treatments

May EL HACHEM ¹, Luigi NALDI ², Iria NERI ³, Maria P. PEDONE ⁴, Francesca FANELLI ⁴, Carlotta GALEONE ⁵ ✉

¹ Dermatology Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy; ² Department of Dermatology, San Bortolo Hospital, Vicenza, Italy; ³ Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; ⁴ Sanofi S.p.A, Milan, Italy; ⁵ Outcome Research Unit, Statinfo, Renate, Monza e Brianza, Italy

INTRODUCTION: The epidemiology of atopic dermatitis (AD) is largely different in pre-school and schoolchildren. We summarized the available epidemiological data on schoolchildren (6-11 years) and adolescents (12-17 years) in Italy and reviewed information on systemic treatments for moderate-to-severe AD in adolescents.
EVIDENCE ACQUISITION: In January 2019, we searched for data on prevalence and/or incidence of AD and on the efficacy, effectiveness and safety of systemic AD therapies. Papers were evaluated and selected, and relevant information was extracted. Twenty papers from 17 studies reported original epidemiological information on AD in Italy.
EVIDENCE SYNTHESIS: Most studies were conducted before 2005. Though variations emerged between studies, the lifetime prevalence of AD was estimated between 15-17% in schoolchildren and between 8-13% in adolescents. The (12-months) period prevalence of AD was estimated between 8-10% in children and between 8-11% in adolescents. Up-to-date information on the prevalence of severe AD is not available. Cyclosporine A may be used in pediatric age patients (children and adolescents) with persistent or severe AD refractory to topical treatments, but its use has several limitations, and is not recommended in patients younger than 16 years. The treatment paradigm of AD is still far from being satisfactory.
CONCLUSIONS: We provided a quantitative synthesis of AD epidemiology in Italian schoolchildren and adolescents. Recent data are needed, as most information dates back to the 1990s or early 2000s, and data on the incidence of AD, the proportion of severe cases, and treatment of severe cases in the real-world setting are scanty.

KEY WORDS: Adolescent; Child; Atopic dermatitis; Epidemiology; Incidence; Prevalence