Clinical Edge

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Childhood AD in the Primary Care Setting

J Am Board Fam Med; 2019 Mar-Apr; Al-Naqeeb, et al

A large burden of childhood atopic dermatitis (AD) exists in the primary care practice setting in the US, a new study found. The cross-sectional survey study estimated the prevalence of AD in children aged 0‒5 years attending primary care practices in the US and described routine skin care practices used in this population. Researchers found:

  • Among 652 children attending primary care practices, the estimated prevalence of ever having AD was 24%.
  • The prevalence of comorbid asthma was higher among AD participants compared to those without AD.
  • 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.


Al-Naqeeb J, Danner S, Fagnan LJ, et al. The burden of childhood atopic dermatitis in the primary care setting: A report from the Meta-LARC Consortium. J Am Board Fam Med. doi:10.3122/jabfm.2019.02.180225.


This survey of primary care practices found a very high (24%) prevalence of AD in children at 5 years of age attending a group of primary care practices. Most of the practice locations were in areas of the US that have colder and drier atmospheric conditions, which may help explain this strikingly high prevalence. Presence of respiratory symptoms was common as well. Before diagnosis, skin care practices may not have been optimum for the atopic child, suggesting an important area for the PCP to address to improve AD control. — Joseph Fowler, Jr., MD, Clinical Professor of Dermatology, University of Louisville, KY