• Jinan Al-Naqeeb, Sankirtana Danner, Lyle J Fagnan, Katrina Ramsey, LeAnn Michaels, Julie Mitchell, Kelsey Branca, Cynthia Morris, Donald E Nease, Linda Zittleman, Barcey Levy, Jeanette Daly, David Hahn, Rowena J Dolor, Hywel C Williams, Joanne R Chalmers, Jon Hanifin, Susan Tofte, Katharine E Zuckerman, Karen Hansis, Mollie Gundersen, Julie Block, Francie Karr, Sandra Dunbrasky, Kathy Siebe, Kristen Dillon, Ricardo Cibotti, Jodi Lapidus, and Eric L Simpson.
• From Department of Dermatology, Oregon Health and Science University, Portland (JA, JH, ST, ELS); Oregon Rural Practice-based Research Network, Oregon Health and Science University, Portland (SD, LJF, LM, KB, KD); Public Health and Preventive Medicine, Oregon Health and Science University, Portland (KR, KEZ, JL); Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland (JM, CM); High Plains Research Network, University of Colorado, Denver (DEN, LZ); Iowa Research Network, University of Iowa, Iowa City (BL, JD); Wisconsin Research and Education Network, University of Wisconsin, Madison (DH); Primary Care Research Consortium, Duke University, Durham, North Carolina (RD); Centre of Evidence-Based Dermatology, University of Nottingham, England (HCW, JRC); Division of General Pediatrics, Oregon Health and Science University, Portland (KEZ); Patient Advocate (KH, MG); National Eczema Association, San Rafael, CA (JB); Mid-Columbia Medical Center, The Dalles, OR (FK); Treasure Valley Pediatric Clinic, Ontario (SD); Winding Waters Clinic, Enterprise (KS); National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD (RC).
• J Am Board Fam Med. 2019 Mar 1; 32 (2): 191200191-200.

BackgroundLittle is known about the burden of atopic dermatitis (AD) encountered in US primary care practices and the frequency and type of skin care practices routinely used in children.ObjectiveTo estimate the prevalence of AD in children 0 to 5 years attending primary care practices in the United States and to describe routine skin care practices used in this population.DesignA cross-sectional survey study of a convenience sample of children under the age of 5 attending primary care practices for any reason.SettingTen primary care practices in 5 US states.ResultsAmong 652 children attending primary care practices, the estimated prevalence of ever having AD was 24% (95% CI, 21-28) ranging from 15% among those under the age of 1 to 38% among those aged 4 to 5 years. The prevalence of comorbid asthma was higher among AD participants compared to those with no AD, namely, 12% and 4%, respectively (P < .001). Moisturizers with high water:oil ratios were most commonly used (ie, lotions) in the non-AD population, whereas moisturizers with low water:oil content (ie, ointments) were most common when AD was present.ConclusionsOur study found a large burden of AD in the primary care practice setting in the US. The majority of households reported skin care practices that may be detrimental to the skin barrier, such as frequent bathing and the routine use of moisturizers with high water: oil ratios. Clinical trials are needed to identify which skin care practices are optimal for reducing the significant burden of AD in the community.© Copyright 2019 by the American Board of Family Medicine.

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