Association Between Early-Onset Atopic Dermatitis and Risk of Asthma in Individuals With a Family History of Atopy: A Systematic Review

Atopic diseases are immune-mediated allergic conditions characterized by hypersensitivity reactions following allergen exposure. The most common ones worldwide include atopic dermatitis (AD), asthma, and allergic rhinitis. AD, an inflammatory skin condition characterized by eczematous skin lesions, often appears as the first manifestation in the atopic march, which is the progression from AD to asthma and other allergic diseases. Our systematic review aims to assess the risk of asthma development in individuals with early-onset AD and a family history of atopy. We collected data from three databases, namely, PubMed, ScienceDirect, and Google Scholar, and conducted a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Initially, we identified 7,261 articles. After screening and quality assessment using various standardized tools, we included 12 high-quality studies in the final review. These comprised eight prospective cohort studies, two retrospective cohort studies, one narrative review, and one systematic review with meta-analysis. Our findings indicate that early-onset AD (within the first two years of life), especially when persistent or severe, significantly increases the risk of developing asthma during childhood. This risk is further amplified in individuals with a family history of atopic diseases. The review underscores early-onset AD and familial atopy as strong predictors of subsequent asthma development. Understanding the natural course of AD and its genetic and immunological links to other allergic conditions is crucial for early identification and preventive strategies.