Trends in eczema in the first 18 years of life: results from the Isle of Wight 1989 birth cohort study

Abstract

Trends in the prevalence of eczema in the course of childhood and adolescence are not clear although often a net remission during childhood is assumed. To investigate the dynamics of change in eczema from 1 to 18 years in a prospective study and to understand the influence of gender and atopy. Detailed information regarding eczema were collected at ages 1, 2, 4, 10 and 18 years from the 1989 Isle of Wight birth cohort (n=1456). Skin prick testing was performed at 4, 10 and 18 years of age. The 12-month period prevalence, positive and negative transitions (defined as change in disease status in two consecutive study assessments) were stratified by gender and atopic status. The period prevalence of eczema from birth to 18 years of age remained relatively constant (11.9-14.2%) with minimal remission. Up to 10 years of age, gender did not influence prevalence. From 10 to 18 years, eczema became more prevalent among girls (16.3% for girls vs. 8.3% for boys, P<0.001) as a result of a greater positive transition in girls (9.4% for girls vs. 4.3% for boys, P=0.001) and greater negative transition in boys (65.4% for boys vs. 50% for girls, P=0.04). The higher positive transition of eczema in girls was most pronounced for non-atopic eczema (5.9% for girls vs. 1.5% for boys, P=0.002). We found only a minimal reduction in the prevalence of eczema during childhood and adolescence. During adolescence, more girls develop eczema and more boys outgrow it suggesting a role for gender-specific pubertal factors.