Eczema is a chronic, inflammatory disease common in both children and adults that causes dry, red, and itchy skin, typically in skin folds, such as the crook of the elbow or behind the knees. An allergic type of ailment, it often coincides with having asthma or seasonal allergies.

The cause of eczema is unknown and believed to be multifactorial, and the physical symptoms of the disease can be debilitating. Eczema has been associated with poor quality of life, and has negative impacts on school, work, and the social lives of those affected by the disease. The skin condition is also associated with negative psychological effects. There are a number of treatment options, but no cure.

Studies have shown that eczema is more common among African-American children than white children, and also may be more severe, for reasons that are unclear.

“Because of the many factors that contribute to the development of eczema, it’s unclear if there are biologic, environmental, social, or other factors that contribute to this difference,” says Junko Takeshita, an assistant professor in the Department of Dermatology and the Department of Biostatistics, Epidemiology and Informatics at the Perelman School of Medicine.

New research from Takeshita and Alexander H. Fischer, a former medical student at Johns Hopkins University, found that although African-American children are more susceptible to eczema and may suffer more serious forms of the disease, they are 30 percent less likely than white children to see a doctor for treatment. The study was published in the Journal of the American Academy of Dermatology.

Takeshita says she became interested in the study through her research focus on health and health care disparities in chronic inflammatory diseases of the skin.

“With eczema being such a common skin disease across all races and ethnicities, and because it has major negative effects on patients’ lives, I thought it was an important disease to focus our research efforts on,” she says.

The researchers utilized data from the Medical Expenditure Panel Survey for their study, the most complete source of data currently available on health care utilization, cost, and insurance coverage in the United States. They found that race alone can be a predictor of whether a child with eczema will see a doctor, independent of other social or demographic factors, or insurance status.

“Our findings suggest that there is something related to a child’s race that is contributing to this difference in health care utilization,” Takeshita says.

The study is the first to look at racial and ethnic differences in health care utilization for eczema on an individual level rather than relying on a sample of outpatient visits, which Takeshita says makes the report “a unique evaluation of eczema that includes those not accessing care for their disease.”

Takeshita says the first step in addressing the problem was identifying that a disparity exists. Equipped with conclusive findings, she says the next step is trying to understand why the racial disparity exists.

“One way to approach this is with qualitative research; in other words, interview children with eczema and their caregivers to try to understand why black children in particular are not getting medical care for their eczema compared to white children,” she says.

The goal of this work, Takeshita says, is to ultimately develop interventions to eliminate the disparity in medical care, and make sure everyone is getting the care they need.