Persistently Elevated Atopic Dermatitis Burden in the Turkish Population: A 34-Year Cross-National Analysis Using Global Burden of Disease 2023 Data

Aim: Atopic dermatitis is the most burdensome skin disease worldwide, but its cross-national burden pattern is not fully characterized in Eastern Mediterranean countries such as Türkiye. Methods: Age-standardized disability-adjusted life-year rates for atopic dermatitis were extracted from the Global Burden of Disease 2023 study for Türkiye, the global average, Greece, Bulgaria, and Germany for 1990–2023, and temporal trends and Türkiye-to-global ratios were calculated using Python 3.12. Results: The age-standardized disability-adjusted life-year rate in Türkiye in 2023 was 339.2 per 100,000 (95% uncertainty interval: 171.4–611.9), 2.28 times the global average, 3.0 times Greece, and 6.5 times Germany, with excess observed throughout the 34-year period (+0.5% versus -5.6% globally). The crude all-age rate fell by 26.5%, while the age-standardized rate remained stable, indicating that this apparent improvement reflects population aging rather than true burden reduction. The Türkiye-to-global ratio rose steadily from 2.15 to 2.28. Loss-of-function mutations in the filaggrin gene are rare or absent in Turkish populations, suggesting alternative disease mechanisms. Conclusion: Türkiye bears a persistent, disproportionate, and mechanistically unexplained burden of atopic dermatitis. Air pollution, rapid urbanization, dietary change, and genetic variants unrelated to the filaggrin gene warrant further investigation through nationally representative epidemiological research integrating genetic, environmental, and clinical data.