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Children with eczema along with other conditions such as ADHD may be prone to learning disabilities. Annie Otzen/Getty Images
  • It’s estimated that 15% to 20% of children worldwide have atopic dermatitis, also known as eczema.
  • Researchers from Johns Hopkins University School of Medicine report that children with atopic dermatitis were more likely to experience difficulties with learning and memory than those without the disease.
  • They added that children with eczema had a two-fold to three-fold greater risk of memory difficulties if they also had a neurodevelopmental disorder such as ADHD or learning disabilities.

Researchers estimate that between 15% and 20% of children around the world have atopic dermatitis.

Also known as eczema, this chronic disorder causes the skin to become dry, itchy, red, and irritated.

Past studies have shown that children who have atopic dermatitis have an increased risk for other conditions such as asthma, skin infections, and food allergies.

Additionally, researchers have linked eczema in children to a higher incidence of neurodevelopmental conditions, including attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder, and learning disabilities.

In a study recently published in the journal JAMA Dermatology, researchers from Johns Hopkins University School of Medicine in Maryland provide more evidence linking eczema to cognitive impairment — such as learning and memory difficulties — in children.

The scientists reported children with atopic dermatitis were more likely to experience difficulties with learning and memory than those without the disease.

They also reported that children with eczema had a two-fold to three-fold greater risk of memory difficulties if they also had a neurodevelopmental disorder such as ADHD or learning disabilities.

In the United States, about 17% of children ages 3 to 17 have one or more developmental disabilities that can affect a child’s learning, language, and behavior skills.

“Cognitive impairment, especially early in life, is linked with poor life outcomes including adverse academic, occupational, and socioeconomic outcomes in later life,” Dr. Joy Wan, an assistant professor of dermatology at Johns Hopkins University School of Medicine and lead author of this study, explained to Medical News Today. “Thus, it’s important to be aware of cognitive deficits, even when mild, so that effective interventions can be pursued as soon as possible.”

Wan said while there has been a growing body of literature linking atopic dermatitis with diagnoses such as ADHD and learning disabilities, studies focusing on symptoms of cognitive impairment — in contrast to relying on reported diagnoses as proxy measures of such — have been fewer and demonstrate inconsistent findings.

“Thus, we were interested in using data from this nationally representative sample of U.S. children to examine whether atopic dermatitis was associated with symptoms of learning or memory difficulties,” she added. “Moreover, we wanted to examine how this relationship is influenced by known neurodevelopmental conditions to further characterize whether specific subgroups of children with atopic dermatitis are more susceptible to cognitive impairments.”

For this study, Wan and her team examined the data from more than 69 million children ages 17 or younger that had been collected from the U.S. National Health Interview Survey in 2021.

A little more than 9 million — or about 13% — of pediatric study participants had atopic dermatitis.

Upon analysis, researchers found that children with atopic dermatitis were more likely to experience difficulties with learning and memory compared to children without the skin condition.

“We were not very surprised by the results because they align with and support previous findings by our group and others that atopic dermatitis is associated with learning disabilities and forgetfulness,” Wan said.

Scientists also discovered that children with eczema and any type of neurodevelopmental disorder, including ADHD or learning disabilities, had a two-fold to three-fold greater chance of experiencing memory issues.

“In some ways, we were not completely surprised because it makes intuitive sense that children who have known diagnoses of ADHD or learning disabilities might be more likely to exhibit symptoms of cognitive impairment than children without these conditions,” Wan said.

“However, what we also observed was an interaction between atopic dermatitis and these neurodevelopmental conditions for memory impairment, which suggests that they may have additive effects on cognitive dysfunction,” she added. “In other words, among only children with ADHD or learning disability, just having atopic dermatitis alone was associated with two-fold to three-fold higher odds of memory difficulties than not having atopic dermatitis.”

Wan said that another interesting finding of the study that adds to the existing literature on this topic is that they found no significant association between atopic dermatitis and learning or memory difficulties among children without known neurodevelopmental conditions.

“(This) is reassuring and may help us to better stratify our patients with atopic dermatitis with respect to their risk for cognitive concerns,” she noted. “While it’s still important for clinicians to inquire about the impact of a child’s atopic dermatitis on their daily functions, including school activities, our results suggest that children without neurodevelopmental concerns such as ADHD or learning disability are not at especially high risk for cognitive impairment and that screening for cognitive impairment should be primarily focused among children with neurodevelopmental diagnoses or concerns.”

“Since the data source in our study did not include any information about atopic dermatitis severity or age of onset, further work is needed to understand how cognitive impairment risk may vary with respect to such factors,” Wan added. “Additionally, we are investigating other risk factors — for example, sleep or comorbid mood symptoms — that might mediate the relationship between atopic dermatitis and cognitive impairment, particularly among children with known neurodevelopmental disorders.”

Dr. Peter Lio, a clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine in Illinois, told Medical News Today that this study does adds some new information to the understanding of childhood eczema as well as confirming previous research.

“We have known for quite some time that there is a powerful connection between atopic dermatitis and some developmental and cognitive issues,” said Lio, who was not involved in the study. “I think it’s important because it underscores that we need to be paying attention to this, particularly in those more moderate to severe patients.”

“Importantly, it’s not entirely clear why this correlation occurs,” he added. “It may have to do with the disease itself causing itch and affecting sleep, which certainly have a powerful impact on the ability to focus and learn. I would like to see deeper explorations into the ‘why.’ Is this an independent correlation or can we really identify factors that are driving it, such that we can begin to develop treatment plans to help prevent this.”

Medical News Today also spoke with Dr. Daniel Ganjian, a pediatrician at Providence Saint John’s Health Center in California, about the study.

“This study supports the entire field of psychodermatology,” said Ganjian, who was not involved in the research. “It shows the strong connection between the mind and the skin. Researchers continue to investigate the potential causes of cognitive impairment in children for a number of reasons.”

“Understanding the causes of cognitive impairment can help in developing better treatments and interventions to improve the lives of children affected by these conditions,” he added. “It can also help to identify children who may be at risk for developing cognitive problems so that they can receive early intervention and support.”