Childhood Atopic Dermatitis Doesn’t Delay Puberty

TOPLINE:

Children with atopic dermatitis (AD), even of greater severity, do not experience a delay in attaining pubertal milestones.

METHODOLOGY:

• Investigators conducted a nationwide cohort study among 15,534 children in Denmark whose pubertal development was assessed every 6 months with a web-based questionnaire starting at the age of 11 years.
• The children were classified into three groups:
  • No AD.
  • Self-reported doctor-diagnosed AD (maternal report of a doctor diagnosis at 6 months, 18 months, and/or 7 years of age).
  • Hospital-diagnosed AD (registry data showing it as the primary reason for hospital contact up to the age of 8 years), representing mainly severe cases.
• The main outcome was the age difference averaged across a range of pubertal milestones (attainment of Tanner stages; development of axillary hair, acne, and voice break; and occurrence of first ejaculation and menarche).

TAKEAWAY:

• Overall, 21.5% of the children had self-reported doctor-diagnosed AD and 0.7% had hospital-diagnosed AD.
• Relative to girls without AD, girls with self-reported doctor-diagnosed AD reached the milestones at the same age, with a mean difference of 0.0 months, and girls with hospital-diagnosed AD reached them a mean of 0.3 months earlier.
• Relative to boys without AD, boys with self-reported doctor-diagnosed AD reached the milestones a mean of 0.1 month later and boys with hospital-diagnosed AD reached them a mean of 0.3 months earlier.
• A more stringent definition of AD — persistent or recurrent AD at 7 years of age (assumed more likely to affect sleep and disrupt the skin barrier near the start of puberty) — was also not associated with delayed pubertal development.

IN PRACTICE:

“Previous studies on AD and puberty are limited, some suggest a link between AD and delayed puberty, akin to other chronic inflammatory diseases in childhood,” the authors wrote. “The results of the present study are reassuring for young patients with AD approaching puberty and reproductive health in adult life,” they concluded.

SOURCE:

The study was led by Camilla Lomholt Kjersgaard, MD, Aarhus University, Aarhus, Denmark, and was published online in JAAD International. 

LIMITATIONS:

Limitations included a lack of information on treatment, the use of analyses that did not address missing data, and a possible misclassification of self-reported pubertal development.

DISCLOSURES:

The study was funded by the Danish Council for Independent Research, Aarhus University, and Fonden af Fam. Kjærsgaard, Sunds, and was co-funded by the European Union. The authors reported no relevant conflicts of interest.