Burden of atopic dermatitis in the United States: National and state-level trends (2010–2021)

Summary: Background: Atopic dermatitis (AD) is a chronic inflammatory skin condition affecting all age groups. While most common in children, its burden in adults is increasing, prompting an updated assessment in the United States from 2010 to 2021. Methods: We used Global Burden of Disease (GBD) 2021 data to estimate age-standardized rates for incidence (ASIR), prevalence (ASPR), and disability-adjusted life years (ASDR) at national and state levels and across demographic groups. Our analysis integrated national surveys, hospital records, and claims databases using Bayesian meta-regression modeling (DisMod-MR 2.1). Estimates were reported with 95% uncertainty intervals (UIs). Results: In 2021, an estimated 9.18 million individuals in the U.S. had atopic dermatitis (95% UI: 8.91–9.48 million), a 2.75% increase since 2010. Incidence reached 922,005 cases (95% UI: 886,551–959,007), reflecting a 1.49% rise over the same period. DALYs increased by 1.7%. In 2021, ASPR for AD was 3,161.5, ASIR was 336.57, and ASDR was 136.56 per 100,000. Females had a 20% higher incidence rate and a 32% higher DALY rate than males, indicating both a higher occurrence of new cases and a greater overall disease burden. Children and adolescents under 20 years had a higher incidence rate than adults. However, compared to 2010, incidence declined in children under 10 years, while prevalence increased in adults, particularly in those aged 25–29 and 65–69 years, highlighting a shifting disease impact across age groups. State-level differences were evident, with Pennsylvania and the District of Columbia reporting the highest rates, while North Dakota had the lowest. Most states saw a slight decline in age-standardized rates, though variations persisted. Conclusion: In the U.S., despite rising total cases, age-standardized AD rates slightly declined, suggesting population growth rather than increased disease risk. The burden remains significant, particularly among adults, and females, with notable state-level variations. Hossein Akbarialiabad¹, Mona Shahriari², Christopher G. Bunick², Ayman Grada³ 1. University of Utah Health, Salt Lake City, UT, United States. 2. Yale University, New Haven, CT, United States. 3. Case Western Reserve University, Cleveland, OH, United States. Clinical Research: Epidemiology and Observational Research