Allergies

Atopic eczema is the most prevalent chronic dermatitis in childhood, characterised by relapsing pruritic lesions and significant heterogeneity in clinical expression and immunological profile. The disease impacts quality of life and healthcare systems, especially when persistent into adulthood. Epidemiological data from the International Study of Asthma and Allergies in Childhood (ISAAC) demonstrate significant geographic and temporal variability in the prevalence of atopic eczema, with an overall upward trend observed in paediatric populations across most regions. A systematic literature search was conducted in PubMed, ScienceDirect, and the Cochrane Library to identify relevant studies published between 1990 and 2025. Seven studies met the inclusion criteria—six cross-sectional and one prospective—conducted in the urban centres of Athens, Thessaloniki, and Patras. Sample sizes ranged from 517 to 3076 participants, encompassing children and adolescents aged 6 to 17. Prevalence rates ranged from 4.5% to 16.1% in children and 8.9% in adolescents, with notable geographic and temporal variability. Male sex, younger age, environmental exposures, and a family history of atopic diseases were identified as key risk factors. Comparative data from European studies reflect similar trends, with increasing atopic eczema prevalence and plateauing asthma rates suggesting distinct etiological pathways. The psychosocial and economic burden of atopic eczema remains substantial, highlighting the need for early recognition and effective management. Despite methodological variability and limitations in study design, findings indicate an underestimation of atopic eczema prevalence in Greece and underscore the importance of standardised epidemiologic surveillance.

Background/Objectives: Atopic dermatitis (AD) is a chronic inflammatory skin disorder increasingly recognized for its association with psychiatric comorbidities. However, the extent of this association compared to dermatologic controls in Asian populations remains underexplored. We sought to evaluate the prevalence and risk of psychiatric comorbidities in adult patients with AD compared to those with melanocytic naevi using a nationwide population-based cohort. Methods: We conducted a retrospective cohort study utilizing the Korean National Health Insurance Service (NHIS) database, including individuals diagnosed with AD (ICD-10 code L20.0) or melanocytic naevi (ICD-10 code D22, excluding melanoma) between 1 January 2010 and 31 December 2023. Patients were required to have at least five years of diagnostic history and be 25 years or older at the end of the study. Psychiatric comorbidities were identified based on ICD-10 codes. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to compare psychiatric morbidity between groups. Results: Among 1,902,114 individuals (1,813,320 with AD and 88,794 with naevi), psychiatric comorbidities were more prevalent in the AD group (28.2%) compared to the naevi group (27.1%) (adjusted OR 1.04, 95% CI 1.02–1.05). While differences for major depression, bipolar disorder, and personality disorders were not statistically significant, other psychiatric categories suggested significantly higher prevalence in the AD group. Sex-stratified analysis revealed a higher overall psychiatric morbidity in women compared to men; however, the relative risk increase associated with AD was slightly greater in men than in women. Comparison with previous international studies suggests that Korea’s healthcare accessibility and nationwide mental health programs may contribute to the smaller observed difference. Conclusions: This large-scale cohort study highlights a modest but significant association between AD and psychiatric comorbidities in adults. Our findings underscore the importance of integrating mental health assessment into routine dermatologic care for AD patients to improve comprehensive disease management.

Glucocorticoids (GCs) remain the cornerstone of asthma treatment due to their potent anti-inflammatory and eosinophil-suppressive effects in the airways, including the induction of peripheral eosinophil apoptosis and downregulation of type 2 cytokine signaling. However, emerging evidence reveals a paradoxical role for GCs in the bone marrow, where they enhance eosinophil production (eosinopoiesis), especially under allergic, infectious, or surgical stress conditions. This duality reflects a complex immunoendocrine interplay involving GC-induced modulation of eosinophil progenitor survival, proliferation, and responsiveness to eosinopoietic cytokines such as interleukin-5 and granulocyte-macrophage colony-stimulating factor. Furthermore, GCs synergize with lipid mediators like cysteinyl-leukotrienes and prostaglandins, modulating both transcriptional and adhesion molecule profiles that prime eosinophil precursors for migration and differentiation. This review examines the molecular and cellular mechanisms underlying GC-induced eosinopoiesis, its functional link to airway inflammation, and its clinical implications for asthma management. We also explore potential therapeutic strategies aimed at selectively modulating bone marrow eosinophil output without compromising the peripheral anti-inflammatory benefits of GCs. Understanding this paradoxical duality holds significant translational potential for improving disease control and preventing asthma exacerbations.