INTRODUCTION
Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by pruritic eczematous lesions and associated adverse health outcomes, including cutaneous symptoms, subsequent sleep disturbance, and mental health impact.1 AD has a high prevalence and is the leading cause of skin-related burden of disease globally.2,3 Disparities in AD health care and variations in clinical presentation have been reported to impact the quality of life (QoL) of patients of color.4-6 This article reviews the nuances in AD epidemiology, clinical presentation, and impact on QoL among US populations with SOC, plus highlights the role of skincare in AD management.
Atopic Dermatitis Epidemiology in Patients With Skin of Color
AD pathogenesis involves a complex interplay of genetic factors, immune dysregulation, defective skin barrier, environmental factors, and microbial dysbiosis.1,7,8
Immunophenotypic and genetic variations between racial/ethnic populations have also been described, including filaggrin gene mutations, plus lipid content and stratum corneum structure differences.11 The most studied genetic variation is filaggrin, which is a structural protein involved in skin barrier function, and filaggrin-2 mutations are associated with AD persistence.
However, African American children with AD show significantly fewer filaggrin mutations, which does not correlate with the increased AD prevalence and persistence in populations with
AD epidemiologic data reports a higher incidence and prevalence among patients with SOC. For example, a study demonstrated that African Americans have 19% AD prevalence compared with 16% in European-Americans counterparts.9,10 Similarly, higher AD prevalence and persistence in children with SOC in the US have been reported.3
Immunophenotypic and genetic variations between racial/ethnic populations have also been described, including filaggrin gene mutations, plus lipid content and stratum corneum structure differences.11 The most studied genetic variation is filaggrin, which is a structural protein involved in skin barrier function, and filaggrin-2 mutations are associated with AD persistence.
However, African American children with AD show significantly fewer filaggrin mutations, which does not correlate with the increased AD prevalence and persistence in populations with
