ASTHMA risk in children with early-onset atopic dermatitis (AD) was significantly elevated, according to a large population-based study analysing nationwide data from South Korea.
AD, a common inflammatory skin condition in infants, has long been considered part of the so-called “atopic march,” in which allergic diseases develop sequentially. However, robust long-term data quantifying asthma risk following early AD have been limited.
Asthma Risk Peaks in Early Childhood
The study included over 1.1 million children diagnosed with AD before the age of two and followed them until adolescence.
Researchers found that asthma prevalence peaked sharply at age three, affecting 29.0% of children with early AD. Although prevalence declined steadily with age, dropping to 0.5% by age 15, it remained consistently higher than in the general population.
These findings reinforce the strong association between early-onset AD and subsequent asthma risk, particularly during early childhood when immune and respiratory systems are still developing.
Key Risk Factors Driving Asthma Risk
Further analysis identified several factors that increased asthma risk among children with early AD.
These included male sex, preterm birth, persistent AD, coexisting food allergies, and early-life respiratory infections such as rhinovirus or respiratory syncytial virus (RSV). Children diagnosed with AD before 2010 also showed a higher risk, although the reasons for this temporal difference remain unclear.
Conversely, children diagnosed with AD after the age of one, as well as those from higher socioeconomic backgrounds, demonstrated a lower likelihood of developing asthma. These findings suggest that both biological and environmental factors play a role in shaping asthma outcomes.
Implications for Early Identification and Prevention
The results highlight the importance of early identification of high-risk children with AD. Clinicians may need to monitor these patients more closely for respiratory symptoms, particularly during the first few years of life when asthma risk is highest.
As the burden of paediatric allergic disease continues to rise globally, targeting modifiable risk factors in early life could help reduce long-term asthma risk and improve outcomes for vulnerable children.
Reference
Kim J et al. Asthma prevalence and risk factors in early-onset atopic dermatitis using Korean National Health Insurance Service data. Sci Rep. 2026;DOI:10.1038/s41598-026-38149-8.
Featured image: marishkaTR on Adobe Stock
