Predicting atopic dermatitis based on parental history of atopic disease

Published online: December 27, 2019

Atopic dermatitis is a chronic, itchy skin disease that typically begins in early childhood and affects about 1 in 5 children. Due to the disease’s common occurrence, chronic nature and profound impact on quality of life, numerous efforts have been made to uncover predictors for atopic dermatitis. Having parents with a history of atopic disease, such as atopic dermatitis, asthma and allergic rhinitis, is considered the strongest and most well-established predictor for development of atopic dermatitis, but several aspects of this association have remained unclear.

In a systematic review and meta-analysis recently published in The Journal of Allergy and Clinical Immunology (JACI), Ravn and colleagues searched large medical databases for articles with data on the association between a parental history of atopic disease and the development of atopic dermatitis. They identified 163 articles with data from 149 unique studies and summarized the data in qualitative and quantitative analyses.

Having parents with a history of atopic disease increased the odds of developing atopic dermatitis, but to different degrees depending on the type of atopic disease. Having parents with a history of atopic dermatitis increased the odds more than 3-fold and approximately twice that of having parents with a history of asthma or allergic rhinitis. It did not affect the association whether it was the mother or father who had a history of atopic disease, but the odds increased with number of parents who had a history of atopic disease and the number of atopic diseases that each parent had.

The study provides evidence-based risk estimates that physicians can use when counseling parents with a history of atopic disease about their child’s risk of developing atopic dermatitis. It also allows for more precise identification of high-risk individuals based on their parents’ history of atopic disease, which is crucial for future efforts towards preventing the development of atopic dermatitis.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.