Skip to main content

Advertisement

SpringerLink
Log in

Environmental Risk Factors for Development of Atopic Dermatitis: a Systematic Review

  • Epidemiology (R Dellavalle, Section Editor)
  • Published:
Current Dermatology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The purpose of this study was to systematically review studies conducted between April 2015 and April 2017 on the environmental risks for the development of AD. We sought to identify (1) environmental risks associated with AD, (2) the proportion of studies for each environmental risk, and (3) environmental risks that need further investigation.

Recent Findings

Recent studies have found genetic predisposition and environmental triggers are involved in the pathogenesis of AD. Genome-wide linkage and candidate gene association studies have led to the linkage of at least 11 different chromosomes and 46 genes. However, the discordance in expression of atopy among monozygotic twins suggests an environmental role.

Summary

Our systematic review found significant risk of development of AD in genetically susceptible children with environmental risk factors of maternal atopy, environmental pollutants, food allergy, and early antibiotic exposure. We suggest future research should aim to better identify environmental pollutants that may increase the development of AD in neonates and children.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Bickers DR, Lim HW, Margolis D, Weinstock MA, Goodman C, Faulkner E, et al. The burden of skin diseases: 2004: a joint project of the American Academy of Dermatology Association and the Society for Investigative Dermatology. J Am Acad Dermatol. 2006;55(3):490–500. doi:10.1016/j.jaad.2006.05.048.

    Article  PubMed  Google Scholar 

  2. Silverberg JI, Garg NK, Paller AS, Fishbein AB, Zee PC. Sleep disturbances in adults with eczema are associated with impaired overall health: a US population-based study. J Investig Dermatol. 2015;135(1):56–66. doi:10.1038/jid.2014.325.

    Article  CAS  PubMed  Google Scholar 

  3. Drucker AM, Wang AR, Li W-Q, Sevetson E, Block JK, Qureshi AA. The burden of atopic dermatitis: summary of a report for the National Eczema Association. J Investig Dermatol. 2017;137(1):26–30. doi:10.1016/j.jid.2016.07.012.

    Article  CAS  PubMed  Google Scholar 

  4. Mounessa J, Braunberger T, Dunnick CA, Dellavalle RP. Minimal improvements in the global burden of skin disease from 1990 to 2013. J Am Acad Dermatol. 2017;76(1):148–149.e2. doi:10.1016/j.jaad.2016.08.006.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Beattie PE, Lewis-Jones MS. A comparative study of impairment of quality of life in children with skin disease and children with other chronic childhood diseases. Br J Dermatol. 2006;155(1):145–51. doi:10.1111/j.1365-2133.2006.07185.x.

    Article  CAS  PubMed  Google Scholar 

  6. Bin L, Leung DYM. Genetic and epigenetic studies of atopic dermatitis. Allergy, Asthma Clin Immunol. 2016;12(1):52. doi:10.1186/s13223-016-0158-5.

    Article  Google Scholar 

  7. Barnes KC. An update on the genetics of atopic dermatitis: scratching the surface in 2009. J Allergy Clin Immunol. 2010;125(1):16–31. doi:10.1016/j.jaci.2009.11.008.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Boguniewicz M, Leung DYM. Atopic dermatitis: a disease of altered skin barrier and immune dysregulation. Immunol Rev. 2011;242(1):233–46. doi:10.1111/j.1600-065X.2011.01027.x.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Strachan DP, Wong HJ, Spector TD. Concordance and interrelationship of atopic diseases and markers of allergic sensitization among adult female twins. J Allergy Clin Immunol. 2001;108(6):901–7. doi:10.1067/mai.2001.119408.

    Article  CAS  PubMed  Google Scholar 

  10. Kuo IH, Yoshida T, De Benedetto A, Beck LA. The cutaneous innate immune response in patients with atopic dermatitis. J Allergy Clin Immunol. 2013;131(2):266–78. doi:10.1016/j.jaci.2012.12.1563.

    Article  CAS  PubMed  Google Scholar 

  11. Cork MJ, Robinson DA, Vasilopoulos Y, Ferguson A, Moustafa M, MacGowan A, et al. New perspectives on epidermal barrier dysfunction in atopic dermatitis: Gene-environment interactions. J Allergy Clin Immunol. 2006;118(1):3–21. doi:10.1016/j.jaci.2006.04.042.

    Article  CAS  PubMed  Google Scholar 

  12. Herrant M, Loucoubar C, Boufkhed S, Bassène H, Sarr FD, Baril L, et al. Risk factors associated with asthma, atopic dermatitis and rhinoconjunctivitis in a rural Senegalese cohort. Allergy, Asthma Clin Immunol. 2015;11(1):24. doi:10.1186/s13223-015-0090-0.

    Article  Google Scholar 

  13. Kwon JH, Kim E, Chang MH, Park EA, Hong YC, Ha M, et al. Indoor total volatile organic compounds exposure at 6 months followed by atopic dermatitis at 3 years in children. Pediatr Allergy Immunol. 2015;26(4):352–8. doi:10.1111/pai.12393.

    Article  PubMed  Google Scholar 

  14. Huang CC, Wen HJ, Chen PC, Chiang TL, Lin SJ, Guo YL. Prenatal air pollutant exposure and occurrence of atopic dermatitis. Br J Dermatol. 2015;173(4):981–8. doi:10.1111/bjd.14039.

    Article  CAS  PubMed  Google Scholar 

  15. • Taylor-Robinson DC, Williams H, Pearce A, Law C, Hope S. Do early-life exposures explain why more advantaged children get eczema? Findings from the U.K. millennium cohort study. Br J Dermatol. 2016;174(3):569–78. doi:10.1111/bjd.14310. Prospective birth cohort study performed in the UK on 14,499 parent-child pairs. Results shows an increased risk of AD development when maternal atopy is present and early antibiotic exposure (<1 year).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. • McNally NJ, Williams HC, Phillips DR, Smallman-Raynor M, Lewis S, Venn A, et al. Atopic eczema and domestic water hardness. Lancet. 1998;352(9127):527–31. doi:10.1016/S0140-6736(98)01402-0. Prospective birth cohort study performed in Spain on 1638 children. This study found no risk of AD associated with exposure to water hardness (measured by calcium carbonate concentration), bath exposure, or both.

    Article  CAS  PubMed  Google Scholar 

  17. Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. doi:10.1371/journal.pmed1000097.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Doğruel D, Bingöl G, Altintaş DU, Yilmaz M, Kendirli SG. Prevalence of and risk factors for atopic dermatitis: a birth cohort study of infants in southeast Turkey. Allergol Immunopathol. 2016;44(3):214–20. doi:10.1016/j.aller.2015.07.002.

    Article  Google Scholar 

  19. Font-Ribera L, Gracia-Lavedan E, Esplugues A, Ballester F, Jiménez Zabala A, Santa Marina L, et al. Water hardness and eczema at 1 and 4y of age in the INMA birth cohort. Environ Res. 2015;142:579–85. doi:10.1016/j.envres.2015.07.013.

    Article  CAS  PubMed  Google Scholar 

  20. Guo MM, Tseng WN, Ou CY, Hsu TY, Kuo HC, Yang KD. Predictive factors of persistent infantile atopic dermatitis up to 6 years old in Taiwan: a prospective birth cohort study. Allergy. 2015;70(11):1477–84. doi:10.1111/all.12706.

    Article  CAS  PubMed  Google Scholar 

  21. Kim J, Han Y, Seo SC, Lee JY, Choi J, Kim KH, et al. Association of carbon monoxide levels with allergic diseases in children. Allergy Asthma Proc. 2016;37(1):e1–7. doi:10.2500/aap.2016.37.3918.

    Article  PubMed  Google Scholar 

  22. Liu W, Cai J, Huang C, Hu Y, Fu Q, Zou Z, et al. Associations of gestational and early life exposures to ambient air pollution with childhood atopic eczema in Shanghai. China Sci Total Environ. 2016;572:34–42. doi:10.1016/j.scitotenv.2016.07.197.

    Article  CAS  PubMed  Google Scholar 

  23. Loo EXL, Shek LPC, Goh A, Teoh OH, Chan YH, Soh SE, et al. Atopic dermatitis in early life: evidence for at least three phenotypes? Results from the GUSTO study. Int Arch Allergy Immunol. 2015;166(4):273–9. doi:10.1159/000381342.

    Article  PubMed  Google Scholar 

  24. • O’Donovan SM, O’B. Hourihane J, Murray DM, Kenny LC, Khashan AS, Chaoimh CN, et al. Neonatal adiposity increases the risk of atopic dermatitis during the first year of life. J Allergy Clin Immunol. 2016;137(1):108–17. doi:10.1016/j.jaci.2015.05.035. Prospective birth cohort study performed in Ireland of 709 parent-child pairs. In contrast to questionnaires used in other studies for diagnosis of AD, a clinician diagnosis was used in analysis. This study found an increased risk of maternal atopy for AD diagnosis at 6 and 12 months.

    Article  PubMed  Google Scholar 

  25. Pesce G, Marcon A, Carosso A, Antonicelli L, Cazzoletti L, Ferrari M, et al. Adult eczema in Italy: prevalence and associations with environmental factors. J Eur Acad Dermatol Venereol. 2015;29(6):1180–7. doi:10.1111/jdv.12784.

    Article  CAS  PubMed  Google Scholar 

  26. Shah L, Mainelis G, Ramagopal M, Black K, Shalat SL. Use of a robotic sampler (PIPER) for evaluation of particulate matter exposure and eczema in preschoolers. Int J Environ Res Public Health. 2016;13(2):1–7. doi:10.3390/ijerph13020242.

    Article  Google Scholar 

  27. Stelmach I, Majak P, Jerzynska J, Podlecka D, Stelmach W, Polańska K, et al. The effect of prenatal exposure to phthalates on food allergy and early eczema in inner-city children. Allergy and Asthma Proc. 2015;36(4):e72–e8. doi:10.2500/aap.2015.36.3867.

    Article  Google Scholar 

  28. Thorsteinsdottir S, Thyssen JP, Stokholm J, Vissing NH, Waage J, Bisgaard H. Domestic dog exposure at birth reduces the incidence of atopic dermatitis. Allergy: Eur J Allergy Clin Immunol. 2016;71(12):1736–44. doi:10.1111/all.12980.

    Article  CAS  Google Scholar 

  29. Wada K, Konishi K, Tamura T, Shiraki M, Iwasa S, Nagata C. Alcohol intake during pregnancy and offspring’s atopic eczema risk. Alcohol Clin Exp Res. 2016;40(5):1037–43. doi:10.1111/acer.13048.

    Article  CAS  PubMed  Google Scholar 

  30. Wang IJ, Tung TH, Tang CS, Zhao ZH. Allergens, air pollutants, and childhood allergic diseases. Int J Hyg Environ Health. 2016;219(1):66–71. doi:10.1016/j.ijheh.2015.09.001.

    Article  CAS  PubMed  Google Scholar 

  31. Wang IJ, Wen HJ, Chiang TL, Lin SJ, Guo YL. Maternal psychologic problems increased the risk of childhood atopic dermatitis. Pediatr Allergy Immunol. 2016;27(2):169–76. doi:10.1111/pai.12518.

    Article  CAS  PubMed  Google Scholar 

  32. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. The international study of asthma and allergies in childhood (ISAAC) steering committee. Lancet (London, England). 1998;351(9111):1225–32. doi:10.1016/S0140-6736(97)07302-9.

    Article  Google Scholar 

  33. Torley D, Futamura M, Williams HC, Thomas KS. What’s new in atopic eczema? An analysis of systematic reviews published in 2010-11. Clin Exp Dermatol. 2013;38(5):449–56. doi:10.1111/ced.12143.

    Article  CAS  PubMed  Google Scholar 

  34. Tsakok T, McKeever TM, Yeo L, Flohr C. Does early life exposure to antibiotics increase the risk of eczema? A systematic review. Br J Dermatol. 2013;169(5):983–91. doi:10.1111/bjd.12476.

    Article  CAS  PubMed  Google Scholar 

  35. Bowatte G, Lodge C, Lowe AJ, Erbas B, Perret J, Abramson MJ, et al. The influence of childhood traffic-related air pollution exposure on asthma, allergy and sensitization: a systematic review and a meta-analysis of birth cohort studies. Allergy. 2015;70(3):245–56. doi:10.1111/all.1256.

    Article  CAS  PubMed  Google Scholar 

  36. Taylan F, Nilsson D, Asad S, Lieden A, Wahlgren CF, Winge MCG, et al. Whole-exome sequencing of Ethiopian patients with ichthyosis vulgaris and atopic dermatitis. J Allergy Clin Immunol. 2015;136(2):507–9. doi:10.1016/j.jaci.2015.02.010.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Medicine, University of Colorado Denver, Aurora, CO, USA

    Nazanin Kuseh Kalani Yazd

  2. Department of Dermatology, University of Colorado Denver, 1665 Aurora Ct, MS 703, Aurora, CO, 80045, USA

    Cory A. Dunnick

  3. Dermatology Service, US Department of Veterans Affairs, Eastern Colorado Health Care System, Denver, CO, USA

    Cory A. Dunnick

Authors
  1. Nazanin Kuseh Kalani Yazd
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cory A. Dunnick
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cory A. Dunnick.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Epidemiology

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yazd, N.K.K., Dunnick, C.A. Environmental Risk Factors for Development of Atopic Dermatitis: a Systematic Review. Curr Derm Rep 6, 169–177 (2017). https://doi.org/10.1007/s13671-017-0189-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13671-017-0189-2

Keywords

Search

Navigation