Longitudinal atopic dermatitis endotypes: An atopic march paradigm that includes Black children.

Background: The atopic march has been studied mostly in White populations, biasing our current paradigms.

Objective: We sought to define the atopic march in Black and White children and explore mechanisms for racial differences.

Methods: Utilizing the Mechanisms of Progression of Atopic Dermatitis to Asthma in Children (MPAACH) cohort (n = 601), we assessed longitudinal sensitization, food allergy (FA), allergic rhinitis, risk of asthma development (through the Pediatric Asthma Risk Score), Scoring for Atopic Dermatitis (SCORAD), transepidermal water loss, skin filaggrin (FLG) expression, exposures, and genetic heritability to define AD progression endotypes in Black and White children.