Predicting eczema severity beyond childhood

• Published in: World journal of pediatrics : WJP 2016-02, Vol.12 (1), p.44-48
• Main Authors: Hon, Kam Lun, Tsang, Yin-Ching K., Poon, Terence Chuen W., Pong, Nga Hin, Kwan, Matthew, Lau, Shirley, Chiu, Yuen-Chun, Wong, Hin-Hei, Leung, Ting-Fan
• Format: Article
• Language: English
• Subjects: Critical Care Medicine; Imaging; Intensive; Maternal and Child Health; Medicine; Medicine & Public Health; Original Article; Pediatric Surgery; Pediatrics; Radiology; Surgery
• ISSN: 1708-8569; 1867-0687
• DOI: 10.1007/s12519-015-0064-9

Background We evaluated factors associated with eczema severity in adolescence. Methods Nottingham Eczema Severity Score (NESS), family and personal history of atopy, skin prick test for common food and aeroallergens, highest serum IgE level and eosinophil count were evaluated. Patients with paired NESSs (childhood-NESS is NESS performed at 10 years) were further analyzed. Results Adolescence-NESS ( n =383 patients) was associated with eczema onset in infancy, dust mite and food allergen sensitization, dietary avoidance, use of wet wrap, traditional Chinese medicine, immunomodulant (azathioprine or cyclosporine), high IgE level, eosinophil count, but not with family/personal history of atopy. Eighty-two patients had both childhood-NESS and adolescence-NESS (mean follow-up of 6.8 years) showing that adolescence-NESS was associated with childhood- NESS severity grades ( P =0.034). Of these patients, 48% remained in the same severity grades, whereas 39% improved, and 13% deteriorated from childhood to adolescence. Conclusions It is not possible to assure parents that their child can outgrow eczema. In eczema prognosis research, long-term follow-up is warranted.