The epidemiology of atopic dermatitis (AD) is heterogeneous across countries and age groups. Traditionally, AD in South Korea has always impacted children more than adults. However, shifts in the country’s socioeconomic and demographic profile over the past two decades could have inadvertently altered who is more susceptible to AD. Lee and colleagues investigated this by conducting a retrospective cohort study, which was published in Nature in April 2024, to evaluate and observe changes in AD prevalence and severity in South Korea across four distinct age groups over 18 years. The study noted a general increase in the prevalence of AD.

The cohort study by Lee and colleagues included 355,277 patients enrolled on the Nation Health Insurance Service National Sample Cohort (NHIS-NSC) for 2002–19. The patients were divided into four age groups: 0–1 year, 2–11 years, 12–19 years, and ≥20 years. Changes in AD prevalence and severity were analyzed. The overall prevalence for all patients without separating by age groups increased from 3.88% in 2002 to 5.03% in 2019 in men and women. Upon breaking down the prevalence by age group, it was found that all age groups except the 0–1 year age group experienced a steady increase in the prevalence of AD from 2002 to 2019. The prevalence for the 2–11 years, 12–19 years, and ≥20 years age groups increased from 12.8%, 2.55%, and 1.14% in 2002 to 15.48%, 6.02%, and 3.53% in 2019, respectively. The 0–1 year age group experienced a much sharper drop in AD prevalence from the start of the study period to the end. Despite the drop in AD prevalence in the 0–1 year age group, its prevalence has continually remained the highest throughout the duration of the study period by a large margin compared to the other age groups. This is particularly true compared to the ≥20 years age group, which had a 3.53% prevalence in 2019 compared to a 24.83% prevalence in 2019 for the 0–1 year age group. The percentage distribution of AD patients by 0–1 year, 2–11 years, 12–19 years, and ≥20 years age groups changed from 20%, 52%, 7%, and 21% in 2002 to 5%, 27%, 9%, and 58% in 2019, respectively. For the overall study period, the moderate to severe group represented 29.82% of patients, and the mild group represented 70.18% of patients. The 12–19 years age group had the highest percentage proportion of moderate to severe AD (43.97%), followed by the ≥20 years age group (41.87%), 2–12 years age group (24.82%), and 0–1 year age group (8.19%).

AD is a chronic inflammatory skin condition that presents as red, flaky, itchy, or dry skin. The extent of the condition can range from a small patch of affected skin to larger areas. AD is the most common form of eczema and can be treated using emollients, topical corticosteroids, and antihistamines. In South Korea, GlobalData epidemiologists estimate that by the end of 2024, there will be just over 800,000 12-month diagnosed prevalent cases of AD in men and women aged 18 years and older. GlobalData has estimated that this will drop to just over 750,000 cases by the end of 2030. This falls in line with knowledge in the literature indicating that adults ages 18 years and older are less vulnerable to AD compared to children.

There are some speculations as to why AD prevalence in adults has grown in the past two decades, including airborne pollution, increased socioeconomic status, psychological stress, and healthcare utilisation. However, for more conclusive reasoning on the shifting epidemiology of AD from decreasing AD prevalence in children to increased AD prevalence in adolescents and adults, further investigation through research is needed.

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