Why a book devoted to the epidemiology of atopic dermatitis?

The title of this book may seem a little esoteric at first glance. But stop for a moment and consider the importance of atopic dermatitis and the need for its epidemiology to be studied.

Atopic dermatitis now affects around 5 to 20% of children worldwide and, like asthma, its prevalence has probably increased two- to threefold over the last 30 years. Recent studies suggest that it is not just a problem confined to northern temperate areas, and that rapidly developing cities throughout the world are witnessing an epidemic of cases. As well as the personal cost to sufferers and their families in terms of itching leading to sleep loss, disfigured skin and secondary infections, recent economic studies have suggested that the financial costs of atopic dermatitis to families and the State are comparable to those of asthma. Unlike asthma, atopic dermatitis is rarely life threatening, yet it is the product of the moderate morbidity multiplied by the high prevalence of this chronic disease which results in an enormous burden of disease in public health terms worldwide.

The last 30 years has witnessed a boom of research into the cellular and molecular mechanism of atopic dermatitis and there have been some interesting breakthroughs. But how has this helped a practitioner like me to help my patients?

Apart from a few drug treatments, which at best partly modify the disease symptoms, the answer is ‘not very much’.