{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:14:30Z","timestamp":1787235270875,"version":"build-2736575974"},"reference-count":87,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med. Sci.","Medical Sciences"],"abstract":"<jats:p>Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease with a relapsing course and a substantial multidimensional burden. Conventional clinical and patient-reported outcome measures mainly provide cross-sectional evaluations and may not fully capture the long-term impact of the disease. The concept of cumulative life course impairment (CLCI) has been proposed to describe the progressive and lifelong consequences of chronic dermatologic conditions. Methods: This narrative review is based on a non-systematic literature search conducted in PubMed\/MEDLINE and Embase up to July 2026. Relevant studies addressing quality of life, mental health, comorbidities, and economic burden in AD were identified and narratively synthesized, with particular focus on evidence supporting the CLCI framework. Results: AD exerts a cumulative burden across multiple domains. Pruritus and sleep disturbance emerge as key drivers, contributing to a self-reinforcing cycle involving psychological distress and impaired daily functioning. Increased rates of anxiety and depression, along with social stigmatization, negatively affect interpersonal relationships, educational attainment, and work productivity. Comorbidities and the chronic relapsing nature of AD further amplify long-term impairment. Economic burden, including both direct and indirect costs, acts as both a consequence and a driver of cumulative disadvantage. Recurrent disease flares play a central role in sustaining and amplifying this trajectory over time. Conclusions: AD should be considered a life-course disease in which interacting biological, psychological, and social factors shape long-term outcomes. A CLCI-oriented approach may improve patient stratification and support earlier, multidisciplinary, and proactive management strategies aimed at reducing long-term burden and improving overall outcomes.<\/jats:p>","DOI":"10.3390\/medsci14040499","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T09:48:31Z","timestamp":1787219311000},"page":"499","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cumulative Life Course Impairment in Atopic Dermatitis: A Comprehensive Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5094-5052","authenticated-orcid":false,"given":"Claudio","family":"Brescia","sequence":"first","affiliation":[{"name":"Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Palagiano","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Turco","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5940-0592","authenticated-orcid":false,"given":"Luca","family":"Potestio","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"di Vico","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3309-8190","authenticated-orcid":false,"given":"Maddalena","family":"Napolitano","sequence":"additional","affiliation":[{"name":"Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1016\/j.jaci.2025.01.013","article-title":"Update on atopic dermatitis","volume":"155","author":"Meledathu","year":"2025","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Savva, M., Papadopoulos, N.G., Gregoriou, S., Katsarou, S., Papapostolou, N., Makris, M., and Xepapadaki, P. (2024). Recent advancements in the atopic dermatitis mechanism. Front. Biosci., 29.","DOI":"10.31083\/j.fbl2902084"},{"key":"ref_3","first-page":"403","article-title":"Adult atopic dermatitis: A review","volume":"151","author":"Napolitano","year":"2016","journal-title":"G. Ital. Dermatol. Venereol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"adv13363","DOI":"10.2340\/actadv.v103.13363","article-title":"Atopic dermatitis in the elderly population","volume":"103","author":"Maurelli","year":"2023","journal-title":"Acta Derm. Venereol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2202","DOI":"10.1111\/all.15741","article-title":"Age of onset defines two distinct profiles of atopic dermatitis in adults","volume":"78","author":"Facheris","year":"2023","journal-title":"Allergy"},{"key":"ref_6","first-page":"355","article-title":"The Dermatology Life Quality Index (DLQI): A fundamental measure of patient-reported outcomes in dermatology","volume":"30","author":"Basra","year":"2012","journal-title":"Dermatol. Clin."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.det.2017.02.002","article-title":"Public Health Burden and Epidemiology of Atopic Dermatitis","volume":"35","author":"Silverberg","year":"2017","journal-title":"Dermatol. Clin."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.jid.2016.07.012","article-title":"The Burden of Atopic Dermatitis: Summary of a Report for the National Eczema Association","volume":"137","author":"Drucker","year":"2017","journal-title":"J. Innov. Dermatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1016\/j.jaip.2020.12.007","article-title":"Sleep Disturbances and Atopic Dermatitis: Relationships, Methods for Assessment, and Therapies","volume":"9","author":"Bawany","year":"2021","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1080\/03007995.2016.1195733","article-title":"The burden of atopic dermatitis in US adults: Results from the 2013 National Health and Wellness Survey","volume":"32","author":"Whiteley","year":"2016","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.jaad.2017.04.019","article-title":"Impact of atopic dermatitis on health-related quality of life and productivity in adults in the United States: An analysis using the National Health and Wellness Survey","volume":"77","author":"Eckert","year":"2017","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"adv00424","DOI":"10.2340\/00015555-3778","article-title":"Impact of Itch on Sleep Disturbance in Patients with Prurigo Nodularis","volume":"101","author":"Gwillim","year":"2021","journal-title":"Acta Derm. Venereol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.jaad.2017.08.002","article-title":"The burden of atopic dermatitis in US adults: Health care resource utilization data from the 2013 National Health and Wellness Survey","volume":"78","author":"Eckert","year":"2018","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1111\/pde.13727","article-title":"The impact of pediatric atopic dermatitis on families: A review","volume":"36","author":"Yang","year":"2019","journal-title":"Pediatr. Dermatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1016\/j.clindermatol.2018.05.011","article-title":"Patient-reported outcomes and quality of life measures in atopic dermatitis","volume":"36","author":"Vakharia","year":"2018","journal-title":"Clin. Dermatol."},{"key":"ref_16","first-page":"2037","article-title":"Mapping risk factors for cumulative life course impairment in patients with chronic inflammatory skin diseases: A systematic review","volume":"35","author":"Augustin","year":"2021","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"0066","DOI":"10.2340\/actadv.v106.adv-2025-0066","article-title":"Atopic Dermatitis Across the Lifespan: Understanding, Measuring and Minimizing Cumulative Life Course Impairment","volume":"106","author":"Augustin","year":"2026","journal-title":"Acta Derm. Venereol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"AB76","DOI":"10.1016\/j.jaad.2012.12.316","article-title":"Evaluation of patient experience of atopic dermatitis with a view of assessing whether life course impairment is cumulative","volume":"68","author":"Wolf","year":"2013","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1626","DOI":"10.1111\/jdv.18977","article-title":"Development of Measurement Tools to Assess Cumulative Life Course Impairment in Patients with Chronic Skin Diseases","volume":"37","author":"Augustin","year":"2023","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_20","first-page":"425","article-title":"Cumulative Life Course Impairment in Moderate-to-Severe Atopic Dermatitis: A Cross-Sectional Study in Sin-gapore","volume":"241","author":"Ho","year":"2025","journal-title":"Dermatology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1111\/j.1525-1470.2005.22303.x","article-title":"The burden of atopic dermatitis: Impact on the patient, family, and society","volume":"22","author":"Carroll","year":"2005","journal-title":"Pediatr. Dermatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/j.jaad.2020.02.055","article-title":"Prevalence of asthma in patients with atopic dermatitis: A systematic review and meta-analysis","volume":"84","author":"Ravnborg","year":"2021","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.anai.2021.02.026","article-title":"Rhinitis prevalence and association with atopic dermatitis: A systematic review and meta-analysis","volume":"127","author":"Knudgaard","year":"2021","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1038\/jid.2013.298","article-title":"Atopic dermatitis and disease severity are the main risk factors for food sensitization in exclusively breastfed infants","volume":"134","author":"Flohr","year":"2014","journal-title":"J. Investig. Dermatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1038\/jid.2014.70","article-title":"Suicidal ideation, mental health problems and social functioning in adolescents with eczema","volume":"134","author":"Halvorsen","year":"2014","journal-title":"J. Investig. Dermatol."},{"key":"ref_26","first-page":"1188","article-title":"Suicidal ideation in adult patients with atopic dermatitis","volume":"97","author":"Gieler","year":"2017","journal-title":"Acta Derm. Venereol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1111\/bjd.18296","article-title":"Increasing severity of atopic dermatitis is associated with a negative impact on work productivity and activity impairment","volume":"182","author":"Andersen","year":"2020","journal-title":"Br. J. Dermatol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Stratigos, A.J., Chasapi, V., Katoulis, A., Vakirlis, E., Psarros, F., Georgiou, S., Vourdas, D., Makris, M., Lazaridou, E., and Gregoriou, S. (2024). Unveiling the Impact of Moderate and Severe Atopic Dermatitis: Insights on Burden, Clinical Characteristics, and Healthcare Resource Utilization in Adult Greek Patients from the APOLO Cross-Sectional Study. J. Clin. Med., 13.","DOI":"10.3390\/jcm13216327"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Napolitano, M., Fabbrocini, G., Kastl, S., Battista, T., Di Guida, A., Martora, F., Picone, V., Ventura, V., and Patruno, C. (2022). Effect of dupilumab on sexual desire in adult patients with moderate-to-severe atopic dermatitis. Medicina, 58.","DOI":"10.3390\/medicina58121708"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1093\/ced\/llae360","article-title":"Sexual impairment in patients with atopic dermatitis","volume":"50","author":"Misery","year":"2025","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"adv35107","DOI":"10.2340\/actadv.v104.35107","article-title":"The Impact of Atopic Dermatitis on Sexual Function and Reproductive Desires in Women","volume":"104","year":"2024","journal-title":"Acta Derm. Venereol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1093\/bjd\/ljaf158","article-title":"Atopic dermatitis starting in childhood has a stronger impact on adults: Results from the \u2019Scars of Life\u2019 international project in 27 countries","volume":"193","author":"Silverberg","year":"2025","journal-title":"Br. J. Dermatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"291","DOI":"10.2340\/00015555-0305","article-title":"Clinical classification of itch: A position paper of the International Forum for the Study of Itch","volume":"87","author":"Weisshaar","year":"2007","journal-title":"Acta Derm. Venereol."},{"key":"ref_34","first-page":"293","article-title":"Mediators of chronic pruritus in atopic dermatitis","volume":"71","author":"Mollanazar","year":"2016","journal-title":"Allergy"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1007\/s40257-016-0198-0","article-title":"Chronic Pruritus in the Absence of Skin Disease: Pathophysiology, Diagnosis and Treatment","volume":"17","author":"Pereira","year":"2016","journal-title":"Am. J. Clin. Dermatol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.2340\/00015555-3296","article-title":"Skin Barrier Damage and Itch: Review of Mechanisms, Topical Management and Future Directions","volume":"99","author":"Yosipovitch","year":"2019","journal-title":"Acta Derm. Venereol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/j.anai.2018.07.006","article-title":"Patient burden and quality of life in atopic dermatitis in US adults","volume":"121","author":"Silverberg","year":"2018","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_38","first-page":"491","article-title":"Sleep disturbance in adults with atopic dermatitis: A systematic review","volume":"75","author":"Yu","year":"2016","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1038\/jid.2014.325","article-title":"Association between atopic dermatitis and sleep disorders in US adults","volume":"135","author":"Silverberg","year":"2015","journal-title":"J. Investig. Dermatol."},{"key":"ref_40","first-page":"352","article-title":"Sleep disorders and atopic dermatitis: A 2-way relationship","volume":"10","author":"Chang","year":"2018","journal-title":"Allergy Asthma Immunol. Res."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Hurel Barroso, M., Oliveira Rodrigues Valle, S., Duarte Dortas Junior, S., Raggio Luiz, R., and Lupi, O. (2024). Sleep and quality of life in adults with atopic dermatitis: Cross sectional study. Eur. Ann. Allergy Clin. Immunol., Epub ahead of printing.","DOI":"10.23822\/EurAnnACI.1764-1489.363"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.sleep.2016.08.006","article-title":"Short sleep duration and health outcomes: A systematic review, meta-analysis, and meta-regression","volume":"32","author":"Itani","year":"2017","journal-title":"Sleep Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s44470-026-00144-1","article-title":"Sleep loss as a cardiometabolic risk factor: A narrative review of clinical and public health implications","volume":"22","author":"Ghanem","year":"2026","journal-title":"J. Clin. Sleep Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1016\/j.beem.2010.08.014","article-title":"Sleep loss and inflammation","volume":"24","author":"Mullington","year":"2010","journal-title":"Best Prac. Res. Clin. Endocrinol. Metab."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1037\/bul0000053","article-title":"Sleep and mental disorders: A meta-analysis of polysomnographic research","volume":"142","author":"Baglioni","year":"2016","journal-title":"Psychol. Bull."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2324","DOI":"10.1111\/jcmm.14170","article-title":"Depression in sleep disturbance: A review on a bidirectional relationship, mechanisms and treatment","volume":"23","author":"Fang","year":"2019","journal-title":"J. Cell. Mol. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e14119","DOI":"10.1111\/jsr.14119","article-title":"Sleep disturbance as a precursor to anxiety, depression, and PTSD among rural Kenyans: A cross-lagged panel analysis from a rural Kenyan interventional cohort","volume":"33","author":"Goodman","year":"2024","journal-title":"J. Sleep Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/j.jaad.2018.03.017","article-title":"Association of atopic dermatitis with depression, anxiety, and suicidal ideation: A systematic review and meta-analysis","volume":"79","author":"Hamann","year":"2018","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1159\/000520159","article-title":"Depression, Anxiety, and Suicidal Ideation in Patients with Atopic Eczema in a Prospective Study in Leipzig, Germany","volume":"183","author":"Kage","year":"2022","journal-title":"Int. Arch. Allergy Immunol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1111\/jdv.16148","article-title":"Depression, anxiety and quality of life in subjects with atopic eczema in a population-based cross-sectional study in Germany","volume":"34","author":"Treudler","year":"2020","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e70129","DOI":"10.1002\/clt2.70129","article-title":"Atopic Multimorbidity in Adults with a Focus on Sensitization Patterns and T Cell Activation","volume":"15","author":"Bialas","year":"2025","journal-title":"Clin. Transl. Allergy"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Zhou, Q., Yang, D., Xiong, C., and Li, X. (2023). Atopic dermatitis and cognitive dysfunction in middle-aged and older adults: A systematic review and me-ta-analysis. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0292987"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1093\/bjd\/ljae176","article-title":"Long-term consequences on stigmatization and disease burden during adulthood among patients with childhood or adolescence-onset atopic dermatitis","volume":"191","author":"Halioua","year":"2024","journal-title":"Br. J. Dermatol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1007\/978-3-031-54513-9_9","article-title":"The economic impact of atopic dermatitis","volume":"Volume 1447","author":"Feldman","year":"2024","journal-title":"Management of Atopic Dermatitis"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1111\/bjd.17696","article-title":"Understanding economic evidence for the prevention and treatment of atopic eczema","volume":"181","author":"Sach","year":"2019","journal-title":"Br. J. Dermatol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1007\/s00403-013-1402-1","article-title":"Willingness to pay and quality of life in patients with atopic dermatitis","volume":"306","author":"Beikert","year":"2014","journal-title":"Arch. Dermatol. Res."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"S43","DOI":"10.1097\/DER.0000000000000795","article-title":"Impact and associations of atopic dermatitis out-of-pocket health care expenses in the United States","volume":"33","author":"Chovatiya","year":"2022","journal-title":"Dermatitis"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2335","DOI":"10.1056\/NEJMoa1610020","article-title":"Two phase 3 trials of dupilumab versus placebo in atopic dermatitis","volume":"375","author":"Simpson","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2169","DOI":"10.1016\/S0140-6736(21)00589-4","article-title":"Safety and efficacy of upadacitinib in combination with topical corticosteroids in adolescents and adults with moderate-to-severe atopic dermatitis (AD Up): Results from a randomised, double-blind, placebo-controlled, phase 3 trial","volume":"397","author":"Reich","year":"2021","journal-title":"Lancet"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1016\/j.jaci.2022.12.002","article-title":"Comorbidities of atopic dermatitis\u2014What does the evidence say?","volume":"151","author":"Thyssen","year":"2023","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1111\/jdv.18919","article-title":"Prevalence of and association between atopic dermatitis and food sensitivity, food allergy and challenge-proven food allergy: A systematic review and meta-analysis","volume":"37","author":"Christensen","year":"2023","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1111\/cod.70074","article-title":"Association Between Atopic Dermatitis and Contact Sensitization: An Updated Systematic Review and Meta-Analysis","volume":"94","author":"Jensen","year":"2026","journal-title":"Contact Dermat."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.anai.2019.04.020","article-title":"Comorbidities and the impact of atopic dermatitis","volume":"123","author":"Silverberg","year":"2019","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1101\/gr.131029.111","article-title":"Temporal shifts in the skin microbiome associated with disease flares and treatment in children with atopic dermatitis","volume":"22","author":"Kong","year":"2012","journal-title":"Genome Res."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1111\/bjd.14566","article-title":"Prevalence and odds of Staphylococcus aureus carriage in atopic dermatitis: A systematic review and meta-analysis","volume":"175","author":"Hennekam","year":"2016","journal-title":"Br. J. Dermatol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1016\/S0140-6736(15)00149-X","article-title":"Atopic dermatitis","volume":"387","author":"Weidinger","year":"2016","journal-title":"Lancet"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Legat, F.J. (2021). Itch in Atopic Dermatitis\u2014What Is New?. Front. Med., 8.","DOI":"10.3389\/fmed.2021.644760"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1111\/j.1468-3083.2010.03705.x","article-title":"Psoriasis: Is the impairment to a patient\u2019s life cumulative?","volume":"24","author":"Kimball","year":"2010","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_69","first-page":"1","article-title":"Cumulative life course impairment in psoriasis: Patient perception of disease-related impairment throughout the life course","volume":"164","author":"Gulliver","year":"2011","journal-title":"Br. J. Dermatol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1159\/000350008","article-title":"Cumulative life course impairment: Evidence for psoriasis","volume":"44","author":"Mattei","year":"2013","journal-title":"Curr. Probl. Dermatol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.abd.2023.08.006","article-title":"Cumulative life course impairment in patients with dermatological diseases, with a focus on psoriasis","volume":"99","author":"Romiti","year":"2024","journal-title":"Bras. Dermatol."},{"key":"ref_72","first-page":"255","article-title":"Impact of different skin conditions on quality of life","volume":"148","author":"Sampogna","year":"2013","journal-title":"G. Ital. Dermatol. Venereol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1089\/derm.2023.0362","article-title":"Impact of Atopic Dermatitis\u00ae on Quality of Life of Caregivers: A Systematic Review and Meta-Analysis","volume":"35","author":"Yap","year":"2024","journal-title":"Dermatitis"},{"key":"ref_74","first-page":"e268","article-title":"The long-term safety of topical corticosteroids in atopic dermatitis: A systematic review","volume":"3","author":"Harvey","year":"2023","journal-title":"Ski. Health Dis."},{"key":"ref_75","first-page":"223","article-title":"Italian S3-Guideline on the treatment of Atopic Eczema\u2014Part 1: Systemic therapy, adapted from EuroGuiDerm by SIDEMAST, ADOI and SIDAPA","volume":"159","author":"Argenziano","year":"2024","journal-title":"Ital. J. Dermatol. Venerol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"e43","DOI":"10.1016\/j.jaad.2023.08.102","article-title":"Guidelines of care for the management of atopic dermatitis in adults with phototherapy and systemic therapies","volume":"90","author":"Davis","year":"2024","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1016\/j.jaad.2017.09.074","article-title":"A systematic review of the safety and efficacy of systemic corticosteroids in atopic dermatitis","volume":"78","author":"Yu","year":"2018","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"e15588","DOI":"10.1111\/dth.15588","article-title":"A 24-weeks real-world experience of dupilumab in adolescents with moderate-to-severe atopic dermatitis","volume":"35","author":"Napolitano","year":"2022","journal-title":"Dermatol. Ther."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"e409","DOI":"10.1111\/jdv.17964","article-title":"Atopic dermatitis exacerbation after Covid-19 vaccination in Dupilumab-treated patients","volume":"36","author":"Potestio","year":"2022","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1111\/jdv.18137","article-title":"Rapid improvement in pruritus in atopic dermatitis patients treated with upadacitinib: A real-life experience","volume":"36","author":"Napolitano","year":"2022","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"e15120","DOI":"10.1111\/dth.15120","article-title":"Dupilumab effectiveness for the treatment of patients with concomitant atopic dermatitis and chronic rhinosinusitis with nasal polyposis","volume":"34","author":"Napolitano","year":"2021","journal-title":"Dermatol. Ther."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.jaci.2022.09.023","article-title":"Safety of upadacitinib in moder-ate-to-severe atopic dermatitis: An integrated analysis of phase 3 studies","volume":"151","author":"Thyssen","year":"2023","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1016\/j.jaip.2025.02.040","article-title":"Long-Term Safety of Abrocitinib in Moder-ate-to-Severe Atopic Dermatitis: Integrated Analysis by Age","volume":"13","author":"Cork","year":"2025","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.jaad.2024.04.026","article-title":"Dupilumab provides sustained effectiveness on patient-reported outcomes and favorable safety in patients with moderate-to-severe atopic dermatitis: Up to 5-year results from the daily practice BioDay registry","volume":"91","author":"Zhang","year":"2024","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_85","first-page":"1044","article-title":"Long-Term Effectiveness and Reasons for Discontinuation of Dupilumab in Patients with Atopic Dermatitis","volume":"160","author":"Boesjes","year":"2024","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.1111\/ijd.17729","article-title":"Diagnostic Performance of GPT-4o and Gemini Flash 2.0 in Acne and Rosacea","volume":"64","author":"Boostani","year":"2025","journal-title":"Int. J. Dermatol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"e1052","DOI":"10.1111\/jdv.20861","article-title":"Large language models in evaluating hidradenitis suppurativa from clinical images","volume":"39","author":"Boostani","year":"2025","journal-title":"J. Eur. Acad. Dermatol. Venereol."}],"container-title":["Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3271\/14\/4\/499\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T10:06:17Z","timestamp":1787220377000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3271\/14\/4\/499"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,20]]},"references-count":87,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["medsci14040499"],"URL":"https:\/\/doi.org\/10.3390\/medsci14040499","relation":{},"ISSN":["2076-3271"],"issn-type":[{"value":"2076-3271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,20]]}}}