Atopic Dermatitis Underrecognized, Undertreated in Patients of Color!
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Skin disease images that are found online or in medical textbooks mostly show white patients, yet atopic dermatitis can be more common and more severe in certain other ethnic groups. In multiple studies in the United States and United Kingdom, Black children are about twice as likely to develop the skin disorder than their White counterparts. In addition, Black and Hispanic children in the US are more likely than White children to visit a primary care doctor or emergency room for atopic dermatitis. And among adults, Blacks are three times more likely and Asian/Pacific Islanders nearly seven times more likely than White people to see a physician for this condition.
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@kakali Genetic ancestry does not seem to explain the higher rates of atopic dermatitis in African Americans. That was the upshot of a 2020 analysis of data from two multiethnic cohorts — 86,893 adults in a large Kaiser Permanente study not specific to eczema (GERA: Genetic Epidemiology Research on Adult Health and Aging), and 5467 subjects aged 2-26 years from the national Pediatric Eczema Elective Registry (PEER). Controlling for household income in the pediatric cohort, Black patients were more likely to have eczema and their disease was more severe and more poorly controlled than White counterparts. And in the Kaiser GERA cohort, after controlling for income and education levels, "you had about twice the risk of having atopic dermatitis if you self-identified as African American or Black, versus White," said study leader Katrina Abuabara, MD, MA, MSCE, associate professor of dermatology at UCSF and associate adjunct professor of epidemiology at UC Berkeley School of Public Health.