Global, regional, and national burden of alopecia areata, atopic dermatitis, and psoriasis, 1990–2021: A systematic analysis for the Global Burden of Disease Study 2021
Xinqan Liu, Qiubai Jin, Ningxin Zhang, Bozhen Huang, Jiarong Wu, Mingyue Liu, Meiqi Sun, Ping SongAbstract
Background:
Three immune-mediated skin diseases, alopecia areata, atopic dermatitis, and psoriasis, impose a substantial burden among nonfatal conditions and are associated with marked cross-regional health disparities.
Objectives:
This study utilized epidemiological data on three immune-mediated skin diseases from 1990 to 2021 with the objective of investigating disease patterns and trends at global, regional, and population levels.
Methods:
This study conducted a secondary analysis of epidemiological data on three immune-mediated skin diseases, including alopecia areata, psoriasis, and atopic dermatitis, obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 database for the years 1990–2021. This study investigates average annual percentage changes in age-standardized incidence rates, age-standardized prevalence rates (ASPRs), and disability-adjusted life years across 204 countries and regions, stratified by the five quintiles of the sociodemographic index (SDI), gender, and 20-year age groups, while also calculating the slope index of inequality and the Concentration Index to quantify the epidemiological trends and health inequities associated with these diseases.
Results:
In 2021, ASPRs for three immune-mediated skin diseases were 215.011 (95% uncertainty intervals (UI): 208.320–221.475), 1,728.507 (95% UI: 1658.507–1798.596), and 515.951 (95% UI: 500.199–531.618) per 100,000 for alopecia areata, atopic dermatitis, and psoriasis, respectively, with only psoriasis incidence rising. All three diseases exhibited a positive correlation with the SDI and significant health inequities; however, the concentration index demonstrated a downward trend. The burden of these diseases was characterized by demographic patterns, with alopecia areata predominantly affecting young and middle-aged women, atopic dermatitis primarily impacting children, and psoriasis being more prevalent among the elderly.
Conclusion:
This study highlights significant health inequities in three immune-mediated skin diseases linked to the SDI, regional development, and racial disparities. It urges researchers and global health organizations to investigate these issues to enhance understanding and inform equitable public health policies for better patient outcomes.