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Although children with atopic dermatitis (AD) were more likely to have learning and memory difficulties than those without AD, those associations mainly occurred among children with existing neurodevelopmental comorbidities.

That's according to study findings published in .

The study ultimately included a weighted sample of 69,732,807 children, 9,223,013 of whom (13.2%) had AD. While patient participants with AD were more likely to experience learning difficulties (10.8% [95% CI 7.8%-15.8%] vs 5.9% [95% CI 5.1%-6.9%]; P<.001) and problems with memory (11.1% [95% CI 8.0%-15.9%] vs 5.8% [95% CI 4.9%-6.9%]; P<.001), AD itself was not associated with learning or memory difficulties among children who did not have neurodevelopmental comorbidities.

Co-author Joy Wan, MD, MSCE, is an assistant professor of dermatology with Johns Hopkins University School of Medicine in Maryland. Wan's discussion with the Reading Room has been edited for length and clarity.

What was the impetus for the study and what were the key questions you wanted to address?

Wan: We were interested in understanding how eczema in children may or may not be related to symptoms of cognitive impairment. This idea came from some studies that had suggested there might be a connection between childhood eczema and various diagnoses that might suggest cognitive impairment (e.g., attention-deficit/hyperactivity disorder (ADHD), forgetfulness). But because a lot of the previous studies looking at this population focused on neurodevelopmental diagnoses, we wanted to understand whether there are actual symptoms that parents are reporting versus known diagnoses.

We used US survey data from the National Health Interview Survey on a continuous basis. This survey asked about two particular symptoms of cognitive impairment: problems with memory and problems with learning. This could help us better assess whether there might be a connection.

How would you summarize what you found?

Wan: We found that parents of children with eczema were more likely to report difficulties with learning or memory than were parents of children without eczema. However, we found no significant association between eczema and learning or memory difficulties among children without any of those coexisting conditions or diagnoses. Most notably, the association between eczema and learning and memory symptoms was primarily focused in the subgroup of kids who already had a known diagnosis of ADHD or something similar.

What guidance would you have for clinicians who treat children with eczema?

Wan: Our findings support the notion that among a general population of children with eczema who don't have any neurodevelopmental disorders, there isn't much significant concern that they are at greater risk for potential cognitive deficits as a result of having eczema. There's some reassurance that can be provided to parents and families of children who just have eczema.

However, for kids who have a known diagnosis of ADHD or a suspected or identified learning problem, I would ask about how the eczema may be potentially contributing to or exacerbating symptoms of their ADHD or their ability to learn and function at school, as part of routine care for eczema.

So, perhaps this is the group we need to really focus on -- not only by screening for potential deficits and cognition, but also by making sure their eczema is optimally controlled.

Do you have any final global takeaways on this topic?

Wan: These are reassuring findings in terms of dissociation between eczema and symptoms of learning and memory problems. But we also potentially identified a higher risk in a subgroup of kids who already have known neurodevelopmental conditions in whom further research should be focused.