The global burden of atopic dermatitis: lessons from the GBD Study - 1990 to 2017.

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The Global Burden of Disease (GBD) Study provides an annually updated resource to study disease-related morbidity and mortality worldwide. Here we present the burden estimates for atopic dermatitis (AD), including data from inception of the GBD project in 1990 until 2017. Atopic dermatitis (AD) ranks 15th among all non-fatal diseases and has the highest disease burden among skin diseases as measured by disability-adjusted life years (DALYs). Overall, the global DALY rate for AD in 1990 was 120.83 (65.37-201.04) and remained similar in 2017 at 123.31 (66.79-205.17) in 2017. The 3 countries with the highest DALY rates of AD were Sweden (326.91 [177.70-547.39]), the United Kingdom (284.15 [154.81-477.66]), and Iceland (276.98 [149.02-464.91]), whereas Uzbekistan (85.14 [45.23-144.49]), Armenia (85.12 [45.83-142.94]) and Tajikistan (85.11 [46.06-143.20]) ranked lowest. The global prevalence rate of AD has remained stable from 1990 to 2017. However, the distribution of AD by age groups shows a bimodal curve with the highest peak in early childhood, decreasing in prevalence amongst young adults and a second peak in middle-aged and older populations. We also found a moderate positive correlation between a country's Gross Domestic Product (GDP) and disease burden. GBD data confirms the substantial worldwide burden of AD, which has remained stable since 1990 but shows significant geographical variation. Lifestyle factors, partially linked to affluence, are likely important disease drivers. However, the GBD methodology needs to be developed further to incorporate environmental risk factors, such as UV exposure, to better understand the geographical and age-related variation in disease burden.

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