PEOPLE living with atopic dermatitis (AD) may face a substantially increased risk of respiratory comorbidities, according to a large global analysis. The study provides the first standardised worldwide estimates of asthma and rhinitis prevalence among individuals with AD, highlighting important implications for clinical management and public health planning.
Atopic Dermatitis Patients Show Higher Odds of Respiratory Disease
Researchers conducted a systematic review of 278 studies and used a hierarchical Bayesian model to generate global, regional, and country-level estimates of respiratory disease burden in AD. The analysis revealed that asthma affected around one in five individuals with AD worldwide, with an estimated prevalence of 20.1%. Rhinitis was even more common, affecting 45.1% of patients, while allergic rhinitis and rhinoconjunctivitis were reported in 41.4% and 30.7% of cases, respectively. Approximately 10.4% of people with AD experienced both asthma and rhinitis simultaneously.
The findings also highlighted substantial geographical variation. Prevalence rates ranged widely, from as low as 2.5% for asthma in Israel to nearly 60% in India, suggesting that environmental, genetic, or healthcare-related factors may influence disease expression. Higher comorbidity rates were also observed in countries such as Cuba, Finland, and Puerto Rico.
Compared with individuals without AD, those with the skin condition were significantly more likely to develop respiratory disease. The odds of asthma were nearly three times higher, while the risk of rhinitis and rhinoconjunctivitis was similarly elevated. Researchers noted that estimates were generally higher when AD diagnoses were confirmed by dermatologists or physicians, underlining the importance of accurate clinical assessment.
Implications for Screening Asthma and Rhinitis in Atopic Dermatitis
The authors suggest that the results reinforce the concept of the “atopic march,” in which inflammatory skin disease may precede or coexist with airway conditions. They emphasised that clinicians should remain alert to respiratory symptoms in patients with AD, particularly in regions where prevalence appears highest.
Although the study synthesised a large volume of global data, the authors acknowledged variability between studies and healthcare systems. Nevertheless, the findings provide a clearer picture of the worldwide burden of respiratory comorbidities in AD and may help inform screening strategies, multidisciplinary care, and future epidemiological research.
Reference
Liu Y et al. Burden and risk of asthma and rhinitis in atopic dermatitis: global estimates from a hierarchical Bayesian model. Br J Dermatol. 2026;doi: 10.1093/bjd/ljag025.
