Epidemiology of Atopic Dermatitis in Japan

  • Takumi TakizawaEmail author
  • Akihiro Morikawa
  • Hirokazu Arakawa


Atopic dermatitis (AD) is a common, chronic, and eczematous skin disease. The prevalence of AD is increasing worldwide and varies among countries. AD prevalence in regions with different climates even within a country is different. A number of genetic mutations have been implicated in the development of AD. Mutations in the filaggrin gene and its frequencies are different between different populations. A wide range in AD prevalence and a rapid increase in prevalence strongly indicate that environmental factors play crucial roles in development of AD. Epigenetics might be key to understanding genetic-environmental interactions in this disease.


Epidemiology Children Environmental factors Climate 


  1. 1.
    Takeuchi S, Esaki H, Furusyo N, Hayashida S, Yamamura K, Tsuji G, et al. Incidence, serum IgE and TARC/CCL17 levels in atopic dermatitis associated with other allergic diseases: an update from the Ishigaki cohort. Acta Derm Venereol. 2015;95(4):480–4. doi: 10.2340/00015555-1989.CrossRefPubMedGoogle Scholar
  2. 2.
    Williams HC. Is the prevalence of atopic dermatitis increasing? Clin Exp Dermatol. 1992;17(6):385–91.CrossRefPubMedGoogle Scholar
  3. 3.
    Takeuchi M, Ueda H. Increase of adult atopic dermatitis (AD) in recent Japan. Environ Dermatol. 2000;7:133–6.Google Scholar
  4. 4.
    Williams H, Robertson C, Stewart A, Ait-Khaled N, Anabwani G, Anderson R, et al. Worldwide variations in the prevalence of symptoms of atopic eczema in the International Study of Asthma and Allergies in Childhood. J Allergy Clin Immunol. 1999;103(1 Pt 1):125–38.CrossRefPubMedGoogle Scholar
  5. 5.
    Odhiambo JA, Williams HC, Clayton TO, Robertson CF, Asher MI, Group IPTS. Global variations in prevalence of eczema symptoms in children from ISAAC Phase Three. J Allergy Clin Immunol. 2009;124(6):1251–1258. e23. doi: 10.1016/j.jaci.2009.10.009.CrossRefPubMedGoogle Scholar
  6. 6.
    Takeuchi S, Esaki H, Furue M. Epidemiology of atopic dermatitis in Japan. J Dermatol. 2014;41(3):200–4. doi: 10.1111/1346-8138.12331.CrossRefPubMedGoogle Scholar
  7. 7.
    Williams HC. Epidemiology of atopic dermatitis. Clin Exp Dermatol. 2000;25(7):522–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Katayama I, Kohno Y, Akiyama K, Aihara M, Kondo N, Saeki H, et al. Japanese guideline for atopic dermatitis 2014. Allergol Int. 2014;63(3):377–98. doi: 10.2332/allergolint.14-RAI-0769.CrossRefGoogle Scholar
  9. 9.
    Futamura M, Ohya Y, Akashi M, Adachi Y, Odajima H, Akiyama K, et al. Age-related prevalence of allergic diseases in Tokyo school children. Allergol Int. 2011;60(4):509–15. doi: 10.2332/allergolint.10-OA-0293.CrossRefPubMedGoogle Scholar
  10. 10.
    Sasaki M, Yoshida K, Adachi Y, Furukawa M, Itazawa T, Odajima H, et al. Environmental factors associated with childhood eczema: findings from a national web-based survey. Allergol Int. 2016;65(4):420–4. doi: 10.1016/j.alit.2016.03.007.CrossRefPubMedGoogle Scholar
  11. 11.
    Saeki H, Oiso N, Honma M, Iizuka H, Kawada A, Tamaki K. Prevalence of atopic dermatitis in Japanese adults and community validation of the U.K. diagnostic criteria. J Dermatol Sci. 2009;55(2):140–1. doi: 10.1016/j.jdermsci.2009.04.004.CrossRefPubMedGoogle Scholar
  12. 12.
    Weiland SK, Husing A, Strachan DP, Rzehak P, Pearce N, Group IPOS. Climate and the prevalence of symptoms of asthma, allergic rhinitis, and atopic eczema in children. Occup Environ Med. 2004;61(7):609–15.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Hamada M, Furusyo N, Urabe K, Morita K, Nakahara T, Kinukawa N, et al. Prevalence of atopic dermatitis and serum IgE values in nursery school children in Ishigaki Island, Okinawa. Jpn J Dermatol. 2005;32(4):248–55.CrossRefGoogle Scholar
  14. 14.
    Okada Y, Kumagai H, Morikawa Y, Akasawa A. Epidemiology of pediatric allergic diseases in the Ogasawara Islands. Allergol Int. 2016;65(1):37–43. doi: 10.1016/j.alit.2015.06.010.CrossRefPubMedGoogle Scholar
  15. 15.
    Garmhausen D, Hagemann T, Bieber T, Dimitriou I, Fimmers R, Diepgen T, et al. Characterization of different courses of atopic dermatitis in adolescent and adult patients. Allergy. 2013;68(4):498–506. doi: 10.1111/all.12112.CrossRefPubMedGoogle Scholar
  16. 16.
    Bieber T. Atopic dermatitis. N Engl J Med. 2008;358(14):1483–94. doi: 10.1056/NEJMra074081.CrossRefPubMedGoogle Scholar
  17. 17.
    Rystedt I. Long term follow-up in atopic dermatitis. Acta Derm Venereol Suppl (Stockh). 1985;114:117–20.Google Scholar
  18. 18.
    van der Hulst AE, Klip H, Brand PL. Risk of developing asthma in young children with atopic eczema: a systematic review. J Allergy Clin Immunol. 2007;120(3):565–9. doi: 10.1016/j.jaci.2007.05.042.CrossRefPubMedGoogle Scholar
  19. 19.
    Thomsen SF. Epidemiology and natural history of atopic diseases. Eur Clin Respir J. 2015;2 doi: 10.3402/ecrj.v2.24642.
  20. 20.
    Spergel JM, Paller AS. Atopic dermatitis and the atopic march. J Allergy Clin Immunol. 2003;112(6 Suppl):S118–27. doi: 10.1016/j.jaci.2003.09.033.CrossRefPubMedGoogle Scholar
  21. 21.
    Dharmage SC, Lowe AJ, Matheson MC, Burgess JA, Allen KJ, Abramson MJ. Atopic dermatitis and the atopic march revisited. Allergy. 2014;69(1):17–27. doi: 10.1111/all.12268.CrossRefPubMedGoogle Scholar
  22. 22.
    Spergel JM. From atopic dermatitis to asthma: the atopic march. Ann Allergy Asthma Immunol. 2010;105(2):99–106; quiz 7–9, 17. doi: 10.1016/j.anai.2009.10.002.CrossRefPubMedGoogle Scholar
  23. 23.
    Furue M, Chiba T, Takeuchi S. Current status of atopic dermatitis in Japan. Asia Pac Allergy. 2011;1(2):64–72. doi: 10.5415/apallergy.2011.1.2.64.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Kohno Y. Identification of causative and exacerbation factors of atopic dermatitis and studies for improvement of living environment to prevent the development and exacerbation of symptoms. Reports of Research on Allergic Disease and Immunology. Ministry of Health, Labour and Welfare of Japan 2006–2007. 2008:173–7.Google Scholar
  25. 25.
    Furue M, Yamazaki S, Jimbow K, Tsuchida T, Amagai M, Tanaka T, et al. Prevalence of dermatological disorders in Japan: a nationwide, cross-sectional, seasonal, multicenter, hospital-based study. J Dermatol. 2011;38(4):310–20. doi: 10.1111/j.1346-8138.2011.01209.x.CrossRefPubMedGoogle Scholar
  26. 26.
    Thomsen SF. The contribution of twin studies to the understanding of the aetiology of asthma and atopic diseases. Eur Clin Respir J. 2015;2:27803. doi: 10.3402/ecrj.v2.27803.CrossRefPubMedGoogle Scholar
  27. 27.
    Schultz LF. Atopic dermatitis: a genetic-epidemiologic study in a population-based twin sample. J Am Acad Dermatol. 1993;28(5 Pt 1):719–23.Google Scholar
  28. 28.
    Palmer CN, Irvine AD, Terron-Kwiatkowski A, Zhao Y, Liao H, Lee SP, et al. Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis. Nat Genet. 2006;38(4):441–6. doi: 10.1038/ng1767.CrossRefPubMedGoogle Scholar
  29. 29.
    Kim JE, Kim JS, Cho DH, Park HJ. Molecular mechanisms of cutaneous inflammatory disorder: atopic dermatitis. Int J Mol Sci. 2016;17(8):E1234. doi: 10.3390/ijms17081234.CrossRefPubMedGoogle Scholar
  30. 30.
    Leung DY. Our evolving understanding of the functional role of filaggrin in atopic dermatitis. J Allergy Clin Immunol. 2009;124(3):494–5. doi: 10.1016/j.jaci.2009.07.041.CrossRefPubMedGoogle Scholar
  31. 31.
    Henderson J, Northstone K, Lee SP, Liao H, Zhao Y, Pembrey M, et al. The burden of disease associated with filaggrin mutations: a population-based, longitudinal birth cohort study. J Allergy Clin Immunol. 2008;121(4):872–877. e9. doi: 10.1016/j.jaci.2008.01.026.CrossRefPubMedGoogle Scholar
  32. 32.
    Nemoto-Hasebe I, Akiyama M, Nomura T, Sandilands A, McLean WH, Shimizu H. FLG mutation p.Lys4021X in the C-terminal imperfect filaggrin repeat in Japanese patients with atopic eczema. Br J Dermatol. 2009;161(6):1387–90. doi: 10.1111/j.1365-2133.2009.09406.x.CrossRefPubMedGoogle Scholar
  33. 33.
    Osawa R, Akiyama M, Shimizu H. Filaggrin gene defects and the risk of developing allergic disorders. Allergol Int. 2011;60(1):1–9. doi: 10.2332/allergolint.10-RAI-0270.CrossRefPubMedGoogle Scholar
  34. 34.
    Akiyama M. FLG mutations in ichthyosis vulgaris and atopic eczema: spectrum of mutations and population genetics. Br J Dermatol. 2010;162(3):472–7. doi: 10.1111/j.1365-2133.2009.09582.x.CrossRefPubMedGoogle Scholar
  35. 35.
    Brown SJ, McLean WH. Eczema genetics: current state of knowledge and future goals. J Invest Dermatol. 2009;129(3):543–52. doi: 10.1038/jid.2008.413.CrossRefPubMedGoogle Scholar
  36. 36.
    Flohr C, Mann J. New insights into the epidemiology of childhood atopic dermatitis. Allergy. 2014;69(1):3–16. doi: 10.1111/all.12270.CrossRefPubMedGoogle Scholar
  37. 37.
    Perkin MR, Craven J, Logan K, Strachan D, Marrs T, Radulovic S, et al. Association between domestic water hardness, chlorine, and atopic dermatitis risk in early life: a population-based cross-sectional study. J Allergy Clin Immunol. 2016;138(2):509–16. doi: 10.1016/j.jaci.2016.03.031.CrossRefPubMedGoogle Scholar
  38. 38.
    Langan SM, Flohr C, Williams HC. The role of furry pets in eczema: a systematic review. Arch Dermatol. 2007;143(12):1570–7. doi: 10.1001/archderm.143.12.1570.CrossRefPubMedGoogle Scholar
  39. 39.
    Sabounchi S, Bollyky J, Nadeau K. Review of environmental impact on the epigenetic regulation of atopic diseases. Curr Allergy Asthma Rep. 2015;15(6):33. doi: 10.1007/s11882-015-0533-1.CrossRefPubMedGoogle Scholar
  40. 40.
    Tan TH, Ellis JA, Saffery R, Allen KJ. The role of genetics and environment in the rise of childhood food allergy. Clin Exp Allergy. 2012;42(1):20–9. doi: 10.1111/j.1365-2222.2011.03823.x.CrossRefPubMedGoogle Scholar
  41. 41.
    Liang Y, Chang C, Lu Q. The genetics and epigenetics of atopic dermatitis-filaggrin and other polymorphisms. Clin Rev Allergy Immunol. 2016;51(3):315–28. doi: 10.1007/s12016-015-8508-5.CrossRefPubMedGoogle Scholar
  42. 42.
    Bin L, Leung DY. Genetic and epigenetic studies of atopic dermatitis. Allergy Asthma Clin Immunol. 2016;12:52. doi: 10.1186/s13223-016-0158-5.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Takumi Takizawa
    • 1
    Email author
  • Akihiro Morikawa
    • 1
  • Hirokazu Arakawa
    • 1
  1. 1.Department of PediatricsGunma University Graduate School of MedicineGunmaJapan

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