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PubMed1984

Changes in the reported prevalence of childhood eczema since the 1939-45 war.

Rates of reported eczema during early childhood were studied in 3 national cohorts of children born in 1946, 1958, and 1970. Overall rates rose from 5.1% in children born in 1946, to 7.3% in those born in 1958, to 12.2% in the 1970 cohort. In the 1958 and 1970 cohorts there was a positive association between eczema and breastfeeding. This relationship remained significant after allowing for parental history of allergy and socioeconomic status. Social classes I and II children born in 1946 were less likely to be reported as having eczema, compared with children from lower social classes, whereas children born into higher social classes in 1958 and 1970 had higher rates. These findings may reflect secular changes in the diagnosis of eczema or may represent a real increase in the disorder. The positive association with breastfeeding in the more recent cohorts suggests a new environmental agent may be crossing in breast-milk. The agent(s) may well be in other infant foods, since the rate of reported eczema in non-breastfed children rose from 5.7% in the 1946 and 1958 cohorts to 11.1% of children born in 1970.

Adolescent↗
PubMed1986

Does natural sensitisation in eczema occur through the skin?

The specificities of serum IgE for the faecal and body antigens of the house-dust mite, Dermatophagoides pteronyssinus, were compared in 69 children with various combinations of asthma, eczema, and/or rhinitis. The concentration of IgE antibodies to the mite body was higher in those with eczema than in those with asthma, but the concentrations of IgE antibodies to the faecal allergen were not significantly different. The ratio of the serum concentration of anti-mite-body IgE to anti-faecal IgE was significantly greater in the children with eczema than in the children with asthma. The results in 4 subjects with rhinitis (2 with and 2 without eczema) support the view that IgE antibodies to the mite body are characteristic of eczema. Sensitisation to mite body and mite faecal particles may occur by different processes; the allergens of mite bodies may penetrate the skin, whereas faecal allergen may enter the body by other route(s).

Adolescent↗
PubMed2006

HLA-C expression pattern is spatially different between psoriasis and eczema skin lesions.

Interactions between genetic and environmental factors underlie the immune dysregulation and keratinocyte abnormalities that characterize psoriasis. Among known psoriasis susceptibility loci (PSORS), PSORS1 on chromosome 6 has the strongest association to disease. Altered expression of some PSORS1 candidate genes has been reported but little is known about HLA-C expression in psoriasis. This study compared expression of major histocompatibility complex class Ia and HLA-C in psoriasis, allergic contact eczema, and normal skin. Although HLA-C was abundant in protein extracts from both eczema and psoriasis, a consistent and intriguing difference in the expression pattern was observed; strong immunoreactivity in the basal cell layer, polarized towards the basement membrane in psoriasis, whereas in eczema lesions HLA-C immunostaining was present mostly in suprabasal cells. Inflammatory cells in the dermis were strongly stained in both diseases. Normal skin epithelium showed less intense but similar HLA-C staining as eczema lesions. HLA class Ia expression overall resembled that of HLA-C in all samples. The distinct HLA-C expression patterns in psoriasis and eczema suggest a functional role in the specific psoriasis immune response and not only a general feature of inflammation.

Blotting, Western↗
PubMed1995

[Herpetic eczema in pregnancy].

HISTORY AND FINDINGS: In a 32-year-old 26-week pregnant woman with atopic eczema densely packed blisters, ca. 1 mm in diameter, developed within the eczema areas, typical of herpetic eczema. This diagnosis was confirmed by identifying the virus under the electronmicroscope and demonstrating herpes simplex virus DNA in the polymerase chain reaction. TREATMENT AND COURSE: During intravenous aciclovir administration (5 mg/kg three times daily for 9 days) the blisters quickly healed. As a bacterial superinfection was suspected (later confirmed by culturing Staphylococcus aureus from a skin swab) the patient was also given erythromycin (500 mg four times daily by mouth for 7 days), as well as fusidic acid cream locally. She delivered a healthy child in the 37th week of pregnancy. CONCLUSION: Herpetic eczema is a serious complication of chronic eczema. If it occurs during pregnancy, the risk or fetal damage by aciclovir must be balanced against the risk of intrauterine herpes simplex infection.

Adult↗
PubMed2005

Prevalence of hand eczema in an adult Swedish population and the relationship to risk occupation and smoking.

Using a postal questionnaire the prevalence of hand eczema was determined in a general population of 11,798 individuals aged 20-77 years who were randomly drawn from the population records. The response rate was 78.1%. One-year prevalence of hand eczema among women varied between 1.9% and 10.8%, with the highest figure among those aged 30-39 years. The corresponding figures for men were 2.3% and 5.6%, with the highest figure among those aged 20-29 years. Lifetime prevalence varied between 5.7% and 16.7% among women and between 5.2% and 9.5% among men. Using multiple logistic regression analysis female sex (OR=1.91, 95% CI 1.47-2.47) and smoking (OR=1.35, 95% CI 1.04-1.75) were independent risk factors for reporting 1-year prevalence of hand eczema, whereas age (OR=0.99, 95% CI 0.97-0.99) was inversely related to the 1-year prevalence of hand eczema. Aggregated risk occupation or categorized occupation such as medical and nursing work, production or service were not significantly associated with 1-year prevalence of hand eczema.

Adolescent↗
PubMed1977

Leukocyte and lymphocyte cyclic AMP responses in atopic eczema.

Lymphocytes from subjects with mild and severe atopic eczema were compared with normal control subjects in regard to their cAMP (3';5'-cyclic adenosine monophosphate) responses to a variety of stimulatory agents. Individuals in the severe eczema group were shown to have a significant diminution in their unstimulated lymphocyte cAMP levels and absolute cAMP responses to 0.5 mM theophylline, 0.5 mM theophyline + 1 micronM epinephrine, 10 mM isoproternol, 1 mM isoproterenol, 10 mM salbutamol, and 3 micron M PGE1. Individuals with mild eczema had a reduced response to 0.5 mM theophylline. The severe eczema groups also differed in a number of these responses from a group of 5 subjects with severe psoriasis. Mixed leukocyte cAMP responses to 10 mM isoproterenol also were examined and found to be diminished in individuals with eczema.

Adolescent↗
PubMed1979

Impaired H2 histamine granulocyte response in active atopic eczema.

Many clinical abnormalities in atopic eczema have been attributed to an imbalance in autonomic nervous system control, specifically a partial blockade of beta-adrenergic responsiveness. The lysosomal enzyme beta-glucuronidase is released from granulocytes during in vitro incubation with complement-activated zymosan particles. Isoproterenol will inhibit the release of this lysosomal enzyme from the granulocyte and the isoproterenol effect is associated with increased granulocyte cyclic AMP formation. In atopic eczema and asthma, this granulocyte response to isoproterenol is impaired. Histamine also inhibits in vitro zymosan induced release of beta-glucuronidase and this is an H2 histamine effect. In asthma, this H2 histamine response is diminished. In the following study, we found a similar impairment in histamine inhibition of beta-glucuronidase release and formation of granulocyte cAMP in atopic eczema. This defect was found only in granulocytes from patients with active eczema. Thus in active atopic eczema, defects in the pharmacological response of the granulocyte are not limited to beta-adrenergic agonists but include H2 histamine activity.

Adult↗
PubMed1976

Infantile eczema: A long-term follow-up study.

A 15-17 year follow-up study was conducted on ninety-nine patients who had suffered from infantile eczema. The persistance of the eczema and the occurrence of related conditions were noted. The persistence of eczema was shown to be greater in those patients with a positive family history of eczema and in those who had developed asthma or hay-fever. An attempt was made to see if the persistence of eczema was affected by the position of the child in the family, and some factors provoking relapses were noted. The patients were also questioned with regard to their achievements in academic examinations, and to their social, artistic and sporting activities. The results showed a success rate in examinations not significantly higher than average. It was not possible to show if there is a particular type of atopic personality. There was no constant characteristic in social or artistic patterns. The group as a whole were normal at the milestones of early development, i.e. walking, talking and reading, and also normal with regard to weight and height.

Adolescent↗
PubMed1979

Immune status in atopic eczema: a survey.

We have searched the literature for data on the in vitro assessment of immune status in atopic eczema patients, and have found much confusion. The major findings are tabulated. It is concluded that atopic eczema is a form of immune deficiency, although it is unclear whether this is a primary or secondary defect. Most authors find a T-lymphocyte deficit while eosinophils, B lymphocytes and serum IgE are increased. Serum IgE levels appear to correlated with severity of eczema symptoms. We have previously suggested that T-lymphocyte levels are overestimated in eczema when fetal calf serum is used in the E-rosette assay. Analysis of the literature for the effect of this serum in the assay confirms that there is a T-lymphocyte deficit in atopic eczema, but that the serum masks it. Thus, much of the confusion surrounding this issue can be resolved.

Eczema↗
PubMed1991

Skin susceptibility in uninvolved skin of hand eczema patients and healthy controls.

Basic physiological characteristics were examined in the uninvolved skin of 39 patients with hand eczema and in 39 healthy controls. Susceptibility to sodium lauryl sulphate (SLS)-induced irritant dermatitis was evaluated by the application of a single 24-h SLS patch test to the upper arm. Transepidermal water loss (TEWL) was measured by an evaporimeter, skin thickness by ultrasound A-scan, blood flow by laser-Doppler flowmetry and skin colour by a chroma meter using the L*a*b* system of the Commission Internationale de l'Eclairage (CIE). No difference in basal TEWL values was found between patients and controls. A decreased skin thickness was found in those with hand eczema as compared to the controls. The hand eczema patients had significantly increased L* and decreased b*-values compared to controls, indicating a more 'fair' skin. Susceptibility to SLS was increased only in patients with acute eczema, indicating that the presence of an active eczema increases the reactivity to irritants of distant uninvolved skin.

Acute Disease↗
PubMed1990

Occupational hand eczema in an industrial city.

Hand eczema in relation to occupation was studied in an industrial city. Questionnaires were sent to 20,000 individuals aged 20-65 years, randomly selected from the population register of the city. Those subjects (1385) considering themselves to have had hand eczema within the previous 12 months were invited to a dermatological examination including patch testing. It was found that the reported 1-year period prevalence of hand eczema in the total sample was 11.8%. The only occupational group reporting a statistically significant higher 1-year period prevalence was service work, 15.4%. Among all occupations, cleaners turned out to have the highest period prevalence, 21.3%. Hand eczema was more common among people reporting some kind of occupational exposure. The most harmful exposure turned out to be to unspecified chemicals, water and detergents and dust and dry dirt. The use of protective gloves is reported and analysed. The most common contact allergy was nickel, followed by cobalt, fragrance-mix, balsam of Peru and colophony. A statistically significant increase in contact allergy to colophony for women in administrative work was found. It is concluded that the type of hand eczema that is mostly dependent on occupation is irritant contact dermatitis.

Adult↗
PubMed2004

Eczema and early solid feeding in preterm infants.

AIMS: To establish whether development of eczema is influenced by feeding practices in preterm infants, while taking account of confounding factors. METHODS: Data were assembled from 257 infants born prematurely and studied to 12 months post-term. Logistic regression analysis was performed to establish the association between feeding practices and eczema, allowing for potential confounding factors including the infants' gender, parental atopic status, social background, and parental smoking habits. RESULTS: For the development of eczema (with or without other symptoms) by 12 months post-term, the introduction of four or more solid foods by or before 17 weeks post-term was a significant risk (odds ratio 3.49). Male infants were at significantly higher risk (odds ratio 1.84). In addition, having non-atopic parents who introduced solid foods before 10 weeks post-term or having at least one atopic parent represented a significant risk scenario (odds ratio 2.94). CONCLUSIONS: Early introduction of a diverse range of solid foods may predispose the preterm infant to eczema development by 12 months post-term. Furthermore, non-atopic parents who practice early as opposed to late introduction of solid foods may be exposing preterm infants to a greater risk of eczema by 12 months post-term.

Adolescent↗
PubMed2004

The introduction of solids in relation to asthma and eczema.

BACKGROUND: Despite scarce scientific evidence, current feeding guidelines recommend delayed introduction of solids for the prevention of asthma and allergy. AIMS: To explore whether late introduction of solids is protective against the development of asthma, eczema, and atopy. METHODS: A total of 642 children were recruited before birth and followed to the age of 5(1/2) years. Main outcome measures were: doctor's diagnosis of eczema ever, atopy according to skin prick test results against inhalant allergens, preschool wheezing, transient wheezing, all defined at age 5-5(1/2) years. Introduction of solids as main exposure measure was assessed retrospectively at age 1 year. RESULTS: There was no evidence for a protective effect of late introduction of solids for the development of preschool wheezing, transient wheezing, atopy, or eczema. On the contrary, there was a statistically significant increased risk of eczema in relation to late introduction of egg (aOR 1.6, 95% CI 1.1 to 2.4) and milk (aOR 1.7, 95% CI 1.1 to 2.5). Late introduction of egg was furthermore associated with a non-significant increased risk of preschool wheezing (aOR 1.5, 95% CI 0.92 to 2.4). There was no statistical evidence of feeding practices playing a different role in the development of asthma and eczema after stratification for parental asthma and atopy status. CONCLUSIONS: Results do not support the recommendations given by present feeding guidelines stating that a delayed introduction of solids is protective against the development of asthma and allergy.

Age Factors↗
PubMed1989

Influence of maternal diet during lactation and use of formula feeds on development of atopic eczema in high risk infants.

OBJECTIVE: To examine the effects of maternal diet during lactation and the use of formula feeds on the development of atopic eczema in infants at risk. DESIGN: Mothers who planned to breast feed exclusively were randomly allocated to either a restricted diet (avoiding milk and other dairy products, eggs, fish, peanuts, and soybeans) or a diet without restrictions. Mothers who did not plan to breast feed were randomly allocated to using one of three formula feeds. SETTING: Child health centre in Canada. SUBJECTS: 97 Mothers who chose to breast feed and 124 mothers who did not. INTERVENTIONS: Restricted diet for 49 mothers who breast fed. Casein hydrolysate formula, soy milk formula, or cows' milk formula for infants not breast fed. MAIN OUTCOME MEASURE: Development of eczema in babies. RESULTS: Infants were followed up over 18 months and examined for eczema. Eczema was less common and milder in babies who were breast fed and whose mothers were on a restricted diet (11/49 (22%) v 21/48 (48%)). In infants fed casein hydrolysate, soy milk, or cows' milk 9/43 (21%), 26/41 (63%), and 28/40 (70%), respectively, developed atopic eczema. CONCLUSIONS: In families with a history of atopic disease [corrected] mothers who breast feed should avoid common allergenic foods during lactation. If they choose not to breast feed a hydrolysate formula should be used.

Bottle Feeding↗
PubMed1997

Investigation into the increase in hay fever and eczema at age 16 observed between the 1958 and 1970 British birth cohorts.

OBJECTIVE: To investigate whether changes in certain perinatal and social factors explain the increased prevalence of hay fever and eczema among British adolescents between 1974 and 1986. DESIGN: Two prospective birth cohort studies. SETTING: England, Wales, and Scotland. SUBJECTS: 11,195 children born 3-9 March 1958 and 9387 born 5-11 April 1970. MAIN OUTCOME MEASURES: Parental reports of eczematous rashes and of hay fever or allergic rhinitis in the previous 12 months at age 16. RESULTS: The prevalence of the conditions over the 12 month period increased between 1974 and 1986 from 3.1% to 6.4% (prevalence ratio 2.04 (95% confidence interval 1.79 to 2.32)) for eczema and from 12.0% to 23.3% (prevalence ratio 1.93 (1.82 to 2.06)) for hay fever. Both conditions were more commonly reported among children of higher birth order and those who were breast fed for longer than 1 month. Eczema was more commonly reported among girls and hay fever among boys. The prevalence of hay fever decreased sharply between social classes I and V, increased with maternal age up to the early 30s, and was lower in children whose mothers smoked during pregnancy. Neither condition varied significantly with birth weight. When adjusted for these factors, the relative odds of hay fever (1986 v 1974) increased from 2.23 (2.05 to 2.43) to 2.40 (2.19 to 2.63). Similarly, the relative odds of eczema rose from 2.02 (1.73 to 2.36) to 2.14 (1.81 to 2.52). CONCLUSIONS: Taken together, changes between cohorts in sex, birth weight, birth order, maternal age, breast feeding, maternal smoking during pregnancy, and father's social class at birth did not seem to explain any of the observed rise in the prevalence of hay fever and eczema. However, correlates of these factors which have changed over time may still underlie recent increases in allergic disease.

Adolescent↗
PubMedDate not supplied

Prevalence and severity of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema in 6- to 7-year-old Nigerian primary school children: the international study of asthma and allergies in childhood.

OBJECTIVE: To determine the prevalence and severity of symptoms of asthma, allergic rhinoconjunctivitis and eczema in Nigerian children aged 6-7 years. SUBJECTS AND METHODS: A cross-sectional study of selected children in primary schools in Ibadan, Nigeria was conducted using phase I of the International Study of Asthma and Allergies in Childhood (ISAAC) format. Standardized questionnaires were distributed to parents and guardians of 2,325 children aged 6-7 years in 31 primary schools randomly selected among 272 in Ibadan. RESULTS: Data was collected from 1,704 children (797 boys and 907 girls; M:F ratio 1:1.14), giving a participation rate of 73.3%. Both recent rhinoconjunctivitis and wheeze were reported by 5.1%, and itchy flexural rash in the past 12 months was reported by 8.5%. The cumulative prevalences of reported symptoms of wheezing, rhinitis and eczema were 7.2, 11.3 and 10.1%, respectively. These symptoms were basically the same among the boys and girls (rhinitis 11.4 vs. 11.2%; eczema 10.7 vs. 9.5%), except for wheezing, which was higher in boys (9.0%) than girls (5.6%), p = 0.015. Current symptoms of rhinitis and atopic eczema were associated with current wheeze and severe wheezing, whereas current symptoms of allergic rhinoconjunctivitis were only associated with severe wheezing attacks. One or more current symptoms occurred in 13.2% of the children, and all three symptoms were reported by 0.5%. CONCLUSION: The study demonstrates a high prevalence of atopic conditions among children 6-7 years old in Ibadan, Nigeria, with more than three fifths of the children who had current wheezing also showing symptoms of other atopic diseases. Children with allergic rhinoconjunctivitis were more likely to have severe wheezing attacks if they had developed atopic eczema before 2 years of age.

Asthma↗
PubMed2004

Antioxidant intake in pregnancy in relation to wheeze and eczema in the first two years of life.

Two thousand women were recruited for a prospective investigation of the influence of maternal antioxidant intake in pregnancy on the development of asthma and eczema in children. A food frequency questionnaire was used to characterize diet during pregnancy and blood antioxidant levels were measured. Postal questionnaires were used to follow up the 1,924 singleton children born to the cohort at 6, 12, and 24 months of age. There were no associations between maternal antioxidant intake and wheezing symptoms and eczema in the children's first year. In the children's second year, maternal vitamin E intake during pregnancy was negatively associated with wheeze in the absence of a "cold" (p for trend 0.010) and, in children whose mothers were atopic, there was a negative association between maternal vitamin E intake and childhood eczema (p for trend 0.024). Maternal vitamin C intake during pregnancy was positively associated with "ever wheeze" and eczema during the children's second year. This study suggests that maternal dietary antioxidant intakes during pregnancy may modify the risks of developing wheeze and eczema during early childhood. Further follow up of the cohort will determine whether maternal diet during pregnancy is associated with asthma and atopic disease in later childhood.

Adult↗
PubMedDate not supplied

Living with eczema: the dermatology patient.

This article gives an overview of eczema, including its assessment, the needs of patients with eczema and the management of eczema. The prevalence of all forms of eczema is unknown but there is evidence that atopic eczema is increasing. Nurses can play a vital role in the management of this condition by giving patients time for explanation and discussion.

Adrenal Cortex Hormones↗