Incidence Of Eczema Research Articles

Analysis of heritability and environmental factors in preschool children with eczema: a case-control study

Eczema is common in children, and its onset is affected by both genetic and environmental factors. We investigated the effects of genetic and environmental factors on the incidence of eczema in preschool children. 515 preschool children with eczema and 515 children participating in the physical examination were enrolled. The study included the incidence of childhood eczema, the child’s birth and feeding conditions, the history of eczema in the parents, and relevant environmental risk factors, and to comprehensively analyze the genetic and environmental factors influencing childhood eczema. Among 1030 children, 173 parents (8.4%) had eczema, with a heritability of 73.59% for boys’ parents and 58.59% for girls’ parents. Multivariate logistic regression results showed that premature infants, low birth weight, children who had used antibiotics before the age of 1 year the living environment between the first year of mother pregnancy and the first year of the child is humid, a father with a history of eczema, a mother with a history of eczema are risk factors for eczema in children. Actively preventing environmental factors related to eczema may be an effective means to reduce the risk of eczema in children.

Associations between abnormal sleep behavior and indoor environmental risk factors among children with a chronic cough in Wuxi, China: a cross-sectional study

BackgroundIndoor environmental factors, such as pet ownership, presence of cockroaches, mattress quality, fuel usage (gas or electricity), use of biomass for cooking and heating, exposure to tobacco smoke or household molds can significantly affect the sleep quality of children with chronic cough. However, data regarding the effects of indoor environmental conditions on sleep in this population are limited. This study aimed to assess the prevalence of abnormal sleep behaviors and to establish associations between indoor environmental factors and sleep behaviors among children with chronic cough in Wuxi, China.MethodsA cross-sectional design was employed in this study, involving children aged 3–18 years. Data on sociodemographic factors, allergies, home environmental exposures, and sleep characteristics of the participants were collected using paper-based questionnaires. The association between indoor environmental factors and sleep behaviors in children with chronic cough was analyzed using logistic regression models.ResultsThe findings demonstrated that the prevalence of chronic cough among children in Wuxi was 15.50%. The chronic cough group exhibited a significantly higher incidence of eczema, wheezing, rhinitis, food allergy, and nasosinusitis than the non-chronic cough group. In addition, children with chronic cough also tended to have a family history of sleep disorders and adenoid hypertrophy (P < 0.01). After adjusting for confounding factors, a significant association was observed between bruxism (teeth grinding) and chronic cough (sometimes: odds ratio [OR] = 1.04; confidence interval [CI] = 1.01–1.08; always: OR = 1.11; CI = 1.04–1.19; P < 0.01). Among children with chronic cough, recent home decoration was associated with sleepwalking (OR = 1.04; CI = 1.00–1.07; P < 0.05), mold exposure was associated with bruxism (OR = 1.15; CI = 1.0–1.31; P < 0.05), and carpet use at home was associated with apnea (OR = 1.09; CI = 1.02–1.17; P < 0.05), twitching during sleep (OR = 1.13; CI = 1.00–1.27; P < 0.01) and morning headache (OR = 1.14; CI = 1.05–1.23; P < 0.01).ConclusionChildren with chronic cough are more prone to some abnormal sleep behaviors than children without chronic cough. Household decoration within a year, household mold exposure, and carpet use were all significantly positively associated with abnormal sleep behaviors in children with chronic cough. Our study provides novel insights into the impact of the indoor environment on children’s sleep and the occurrence of chronic cough, offering guidance for tailored health promotion programs for families.

Endotypes of severe neutrophilic and eosinophilic asthma from multi-omics integration of U-BIOPRED sputum samples.

Clustering approaches using single omics platforms are increasingly used to characterise molecular phenotypes of eosinophilic and neutrophilic asthma. Effective integration of multi-omics platforms should lead towards greater refinement of asthma endotypes across molecular dimensions and indicate key targets for intervention or biomarker development. To determine whether multi-omics integration of sputum leads to improved granularity of the molecular classification of severe asthma. We analyzed six -omics data blocks-microarray transcriptomics, gene set variation analysis of microarray transcriptomics, SomaSCAN proteomics assay, shotgun proteomics, 16S microbiome sequencing, and shotgun metagenomic sequencing-from induced sputum samples of 57 severe asthma patients, 15 mild-moderate asthma patients, and 13 healthy volunteers in the U-BIOPRED European cohort. We used Monti consensus clustering algorithm for aggregation of clustering results and Similarity Network Fusion to integrate the 6 multi-omics datasets of the 72 asthmatics. Five stable omics-associated clusters were identified (OACs). OAC1 had the best lung function with the least number of severe asthmatics with sputum paucigranulocytic inflammation. OAC5 also had fewer severe asthma patients but the highest incidence of atopy and allergic rhinitis, with paucigranulocytic inflammation. OAC3 comprised only severe asthmatics with the highest sputum eosinophilia. OAC2 had the highest sputum neutrophilia followed by OAC4 with both clusters consisting of mostly severe asthma but with more ex/current smokers in OAC4. Compared to OAC4, there was higher incidence of nasal polyps, allergic rhinitis, and eczema in OAC2. OAC2 had microbial dysbiosis with abundant Moraxella catarrhalis and Haemophilus influenzae. OAC4 was associated with pathways linked to IL-22 cytokine activation, with the prediction of therapeutic response to anti-IL22 antibody therapy. Multi-omics analysis of sputum in asthma has defined with greater granularity the asthma endotypes linked to neutrophilic and eosinophilic inflammation. Modelling diverse types of high-dimensional interactions will contribute to a more comprehensive understanding of complex endotypes. Unsupervised clustering on sputum multi-omics of asthma subjects identified 3 out of 5 clusters with predominantly severe asthma. One severe asthma cluster was linked to type 2 inflammation and sputum eosinophilia while the other 2 clusters to sputum neutrophilia. One severe neutrophilic asthma cluster was linked to Moraxella catarrhalis and to a lesser extent Haemophilus influenzae while the second cluster to activation of IL-22.

Detailed review of dermatology department consultations in hospital and emergency settings at a tertiary medical center in Mexico

Background: Dermatological consultations are crucial in the treatment of hospitalized and emergency patients. This study examines the scope and characteristics of skin disorders at a tertiary Mexican medical center. Materials and Methods: This descriptive, observational, retrospective study spanned two years and involved 1,134 patients. It aimed to evaluate the types and frequencies of dermatological consultations in both emergency and inpatient settings. Results: Infectious dermatoses, particularly soft tissue infections, were the most common in emergency settings, contrasting with a higher incidence of eczema and dermatitis in inpatient care. The study presents comprehensive statistical analyses linking dermatological conditions with patient demographics and specific hospital departments. Conclusion: This study highlights the essential role of dermatologists in hospital environments, particularly, in identifying and treating infectious skin conditions. It underscores the necessity for specialized dermatological expertise in both emergency and inpatient departments, contributing significantly to patient care and management strategies in hospital settings. Key words: Dermatology, Consultations, Skin Infections, Hospital, Emergency

Prenatal risk factors of indoor environment and incidence of childhood eczema in the Japan Environment and Children's Study

The quality of indoor environment is a risk factor for early childhood eczema and atopic dermatitis; however, its influence during pregnancy on childhood eczema in Japan has not been investigated. In this study, we aimed to determine the indoor environmental factors that are associated with eczema in children up to 3 years of age, using national birth cohort data from the Japan Environment and Children's Study (JECS).Information on indoor environments and eczema symptoms until 3 years of age was collected using self-administered questionnaires to the mothers. A total of 71,883 and 58,639 mother-child pairs at 1.5- and 3-years-old, respectively, were included in the former analyses. To account for prenatal indoor risk factors, 17,568 (1.5-years-old) and 7063 (3-years-old) children without indoor mold and/or ETS exposure were included in the final analysis. A higher mold index, gas heater use, parquet flooring use, and frequent insecticide use showed significantly increased risks for childhood eczema up to 3 years of age. These associations were consistent after stratification analysis among children whose parents did not have a history of allergies. The updated WHO guidelines on indoor air quality should be implemented based on recent findings regarding the effects of prenatal exposure to indoor dampness on health effects of children further in life, including asthma, respiratory effects, eczema, and other immunological effects.

The relationship between umbilical cord blood IL-22 level and infantile eczema at 42 days.

The occurrence of eczema is related to helper T 22 (Th22) cytokine disorder, and Th22 mainly secretes interleukin-22 (IL-22). This study aims to investigate the predictive value of umbilical cord blood IL-22 levels on the onset of eczema in infants within 42 days. The study selected 157 full-term healthy neonates born between September 2020 and May 2021. Cord blood was collected immediately after birth to determine IL-22 levels, and the infants were followed up for 42 days to assess the incidence of eczema. Among the 157 infants who completed the 42-day follow-up, 86 developed eczema and 71 did not. The level of IL-22 in the umbilical cord blood of the eczema group was lower than that of the non-eczema group (p < 0.05). Additionally, the incidence of eczema in children whose Family history of allergy was significantly higher than in the group without eczema (p < 0.05). Logistic regression analysis indicated that low cord blood IL-22 levels and a family history of allergies were independent risk factors for eczema (p < 0.05). The ROC curve of cord blood IL-22 levels and infant eczema showed that the cut-off value is 36.362 pg/ml, the area under the curve (AUC) is 0.613, the standard error is 0.045, the 95% CI is 0.526-0.701, the sensitivity is 63.4%, and the specificity is 57.0%. Therefore, there is a certain correlation between cord blood IL-22 levels and the incidence of infant eczema. Low IL-22 levels in umbilical cord blood may be linked to the development of infant eczema within 42 days, indicating a potential predictive value, although this value appears to be limited.

Prevalence and incidence of hand eczema in healthcare workers: A systematic review and meta-analysis.

Healthcare workers (HCWs) are considered a high-risk group for developing hand eczema (HE), mainly owing to wet work and contact with allergens at work. To meta-analyse the prevalence and incidence of HE in HCWs, as well as mapping the prevalence of atopic dermatitis (AD) and HE severity in HCWs. A systematic review and meta-analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 guidelines. Published literature from 2000 to 2022 was eligible based on predefined inclusion and exclusion criteria. A total of 18 studies were included. Pooled life-time, 1-year and point prevalence of self-reported HE in HCWs was 33.4% (95% confidence interval [CI]: 28.3-38.6), 27.4% (95% CI: 19.3-36.5) and 13.5% (95% CI: 9.3-18.4), respectively. AD prevalence was 15.4% (95% CI: 11.3-19.9). Overall, the majority of HCWs reported mild HE. One included study assessed HE incidence reporting 34 cases/1000 person years. Most studies scored low-moderate using the New Ottawa Scale and the pooled point prevalence data showed broad CIs. In conclusion, the high prevalence of HE in HCWs underlines the increased risk and need for preventive measures for this professional group. There is, however, a need of further standardized high-quality studies.

Environmental Influences on Atopic Eczema.

The health outcomes of an individual are shaped by a combination of genetic predisposition and environmental influences. While some diseases stem solely from environmental factors, others like atopic eczema, also known as neurodermatitis or atopic dermatitis, are multifaceted, with environmental variables playing a significant role in its initiation and severity. Atopic eczema is a prevalent chronic condition observed globally, particularly in Western industrialized nations where its prevalence is estimated to range from 2.5% to 3.5% in adults and 10% to 15% among children. The increasing incidence of atopic eczema in industrialized countries over recent decades suggests that this trend may be due to environmental changes rather than genetic predispositions. Therefore, by thoroughly examining environmental factors and their role in atopic dermatitis, one may be able to gain a better understanding of its disease pattern and develop possible preventative measures. This article provides a comprehensive analysis of how the surrounding environment contributes to the pathogenesis of atopic eczema.

Risk of Paradoxical Eczema in Patients Receiving Biologics for Psoriasis

Biologics used for plaque psoriasis have been reported to be associated with an atopic dermatitis (AD) phenotype, or paradoxical eczema, in some patients. The risk factors for this are unknown. To explore risk of paradoxical eczema by biologic class and identify factors associated with paradoxical eczema. This prospective cohort study used data from the British Association of Dermatologists Biologics and Immunomodulators Register for adults treated with biologics for plaque psoriasis who were seen at multicenter dermatology clinics in the UK and Ireland. Included participants were registered and had 1 or more follow-up visits between September 2007 and December 2022. Duration of exposure to tumor necrosis factor (TNF) inhibitors, interleukin (IL) 17 inhibitors, IL-12/23 inhibitors, or IL-23 inhibitors until paradoxical eczema onset, treatment discontinuation, last follow-up, or death. Incidence rates of paradoxical eczema, paradoxical eczema risk by biologic class, and the association of demographic and clinical variables with risk of paradoxical eczema were assessed using propensity score-weighted Cox proportional hazards regression models. Of 56 553 drug exposures considered, 24 997 from 13 699 participants were included. The 24 997 included exposures (median age, 46 years [IQR, 36-55 years]; 57% male) accrued a total exposure time of 81 441 patient-years. A total of 273 exposures (1%) were associated with paradoxical eczema. The adjusted incidence rates were 1.22 per 100 000 person-years for IL-17 inhibitors, 0.94 per 100 000 person-years for TNF inhibitors, 0.80 per 100 000 person-years for IL-12/23 inhibitors, and 0.56 per 100 000 person-years for IL-23 inhibitors. Compared with TNF inhibitors, IL-23 inhibitors were associated with a lower risk of paradoxical eczema (hazard ratio [HR], 0.39; 95% CI, 0.19-0.81), and there was no association of IL-17 inhibitors (HR, 1.03; 95% CI, 0.74-1.42) or IL-12/23 inhibitors (HR, 0.87; 95% CI, 0.66-1.16) with risk of paradoxical eczema. Increasing age (HR, 1.02 per year; 95% CI, 1.01-1.03) and history of AD (HR, 12.40; 95% CI, 6.97-22.06) or hay fever (HR, 3.78; 95% CI, 1.49-9.53) were associated with higher risk of paradoxical eczema. There was a lower risk in males (HR, 0.60; 95% CI, 0.45-0.78). In this study, in biologic-treated patients with psoriasis, paradoxical eczema risk was lowest in patients receiving IL-23 inhibitors. Increasing age, female sex, and history of AD or hay fever were associated with higher risk of paradoxical eczema. The overall incidence of paradoxical eczema was low. Further study is needed to replicate these findings.

Predicting facial eczema risks in a changing New Zealand climate

Facial eczema is a major concern for New Zealand farmers due to its economic impact and animal welfare implications. The disease occurs when animals ingest sporidesmin, a mycotoxin produced by spores of the fungus Pseudopithomyces chartarum. Spore production is related to weather conditions; thus the incidence and severity of facial eczema varies between years, with thedisease commonly occurring from late summer through autumn in the North Island. We developed a simple model to estimate climatic suitability for P. chartarum sporulation and ran it using climate data for 2008-2021 to compare its estimates with spore counts from the same years. Model climatic suitability estimates had significant linear correlations with an index of exposure to spores derived from spore counts at both national and local scales. Model results were also consistent with a documented outbreak of facial eczema. Using predicted future climate data from the Hadley Centre Global Environment Model version 2 and two emissionsscenarios, the model suggested climatic suitability for P. chartarum sporulation will increase with time in many New Zealand regions, particularly in the southern North Island and eastern parts of the South Island. However, it could remain relatively static in some other areas, thus the degree of change in climatic suitability for P. chartarum sporulation is predicted to vary between New Zealand regions.

Co-occurring ASD Mediates Impact of ADHD on Atopic Dermatitis and Acne: A Retrospective Cohort Study

Background: ADHD and ASD are associated with dermatologic manifestations, yet little research investigates co-occurring ADHD/ASD and common dermatologic conditions. Objective: To investigate associations between ADHD, ASD, acne vulgaris, and atopic dermatitis. Methods: Using de-identified patient records from the TriNetX database, we created four cohorts on ADHD diagnosis, ASD diagnosis, both, neither. Cohorts were separated into males and females. We balanced each cohort based on age, sex, race, and ethnicity to the baseline cohort with neither ASD or ADHD. Finally, we examined prevalence of acne and eczema. Results: The cohort sizes varied from 19,764 to 345,626. Compared to matched peers, males with ADHD or ADHD/ASD had increased prevalence of acne, and all neurodivergent males had increased prevalence of eczema. Females with ADHD had an increase in both. Females with ADHD/ASD had no significant differences, and females with ASD had a decreased risk of eczema. Limitations: Due to database limitations, we are unable to: analyze symptom severity, skincare routine, or treatment adherence. Conclusions: The decreased risk of eczema in females with ASD and lack of significant difference in incidence of acne or eczema in females with ADHD/ASD compared to matched peers suggests research into approaches to skincare in males versus females with ASD may provide clinically relevant insights.

Does exclusive breastfeeding versus cow's milk formula exposure or length of breastfeeding decrease the incidence of pediatric asthma or eczema?

Schuler, Cynthia MD, MSW, FAAFP; Coy, Brandon MD; Folorunsho, Adesoji MD Author Information

Maternal dietary patterns during pregnancy and the risk of infantile eczema during the first year of life: a cohort study in northeast China

BackgroundThere are few studies on the relationship between diet during pregnancy and infantile eczema and the conclusions are inconsistent. The aim of the present study was to explore the impact of dietary patterns during pregnancy on infantile eczema.MethodsA total of 495 mother–child pairs from a prospective cohort in Shenyang, China was recruited. Information on maternal dietary intake during pregnancy was assessed with a validated self-administered food frequency questionnaire. The data of infantile eczema was assessed using a structured questionnaire. Factor analysis to derive dietary patterns. The relationship between the dietary pattern and infantile eczema was examined by the logistic regression analysis.ResultsThe cumulative incidence of eczema in 6 months and 12 months in northeast China was 45.7% and 57.8%, respectively. Three dietary patterns were identified. There was a tendency for an expose-response relationship between the maternal high-protein dietary pattern during pregnancy and the risk of infantile eczema within 12 months (P for trend = 0.023): the adjusted odds ratio (95% confidence interval) in the Q1, Q2, Q3, Q4 were 1.00 (reference), 1.63 (0.96–2.76), 1.81 (1.06–3.06), and 1.87 (1.09–3.20), respectively. No association between Western and plant-based patterns during pregnancy and infantile eczema within 12 months was found. Infantile eczema within 6 months was not associated with any of the three dietary patterns.ConclusionThe maternal high-protein pattern during pregnancy may be a risk factor for infantile eczema during the first year of life.

Medicinal effects of microbubble bath on atopic eczema and psoriasis vulgaris

The incidence of atopic eczema in the population reaches generally up to 25%. Skin dis-eases such as Atopic eczema and Psoriasis vulgaris are a worldwide problem. Use of topi-cal corticosteroids is the first-line treatment for atopic dermatitis flare-ups. Last individual case studies led to the hypothesis: Baths with microbubbles in tap water can significantly support the treatment of skin diseases. Microbubbles penetrate deep into the skin pores. Micro implosions occur on the pore walls, which mechanically affect nerve endings and vascular microcapillaries. In addition, due to the implosion of microbubbles, the mechan-ical effect leads to an increased release and flushing of substances contained in the skin pores. A total of 30 patients were selected for the study, of which 15 were included in the Study Group and 15 in the Control Group. The effects were monitored on the objectively evaluable dermatological calculators PASI, EASI, SCORAD, and DLQI Score, Quality of life, and Number and condition of foci. The project responded to the hypothesis that mi-crobubbles in the water phase, produced by special generators, in the size range of 1-100 µm, may in the future become a fundamental innovation in balneological treatment in the form of new treatment procedures.

Trends in the Prevalence of Eczema Among US Children by Age, Sex, Race, and Ethnicity From 1997 to 2018

This cross-sectional study of National Health Interview Survey data examines differences among sociodemographic subgroups in reported incidence of eczema in children in the US.

Is antenatal or early-life vitamin D associated with eczema or food allergy in childhood? A systematic review.

To summarise the associations between antenatal or early-life blood vitamin D and the development of eczema/food allergy in childhood. A systematic review and meta-analyses were conducted to synthesize the published literature. Two reviewers independently performed the study selection and data extraction on Covidence. We assessed the risk of bias for observational studies by using the Newcastle-Ottawa Scale and the Cochrane Risk of Bias tool for clinical trials. The certainty of the evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluations (GRADE). We systematically searched PubMed and Embase from inception and April 2022. Human studies that investigated prospective associations between antenatal or early-life blood vitamin D levels, dietary intake or supplementation and childhood eczema/food allergy. Forty-three articles including six randomised controlled trials (RCTs) were included. Four RCTs of vitamin D supplementation during pregnancy showed no evidence of an effect on the incidence of eczema (pooled odds ratio [OR]=0.85; 0.67-1.08, I2 = 6.7%, n= 2074). Three RCTs reported null associations between supplementation in pregnancy/infancy and food allergy. From six cohort studies, increasing cord blood vitamin D levels were associated with reduced prevalence of eczema at/close to age one (OR per 10 nmol/L increase=0.89; 0.84-0.94, I2 = 0%, 2025 participants). We found no evidence of an association between maternal antenatal or infant vitamin D level or dietary intake and the development of food allergy or eczema in offspring. We found an association between higher vitamin D levels in cord blood and reduced risk of eczema in cohort studies. Further trials with maternal and infant supplementation are needed to confirm if vitamin D supplementation can effectively prevent eczema or food allergy in childhood. PROSPERO, No. CRD42013005559.

Ayurveda compound formulations “Panchatikta ghrita” and “Gandhakadya malahara” in the management of Vicharchika (atopic eczema): A prospective open-label clinical trial

ABSTRACT Background: Eczema or atopic dermatitis is one of the significant public health concerns worldwide. Its prevalence is estimated to be 15–20% in children and 1–3% in adults. Moreover, the incidence of eczema has increased by 2–3-folds during the past decades in industrialized countries. The condition can considerably impact the quality of life of the affected individual by causing physical discomfort, emotional distress, sleep disturbance, and restriction of domestic and social activities. Objectives: The present study was intended to assess the efficacy of Panchatikta Ghrita (PTG) as Shamana sneha (~internal medication for unctuous therapy) and the external application of Gandhakadya Malahara (GKM) in Vicharchika vis-à-vis eczema. Materials and Methods: A prospective open-label clinical trial was conducted in 101 participants of aged between 18 and 60 years with atopic eczema. PTG was given a dose of 10 gm twice daily before food with lukewarm water. GKM was advised for external application twice a day for 12 weeks. The participants were assessed based on cardinal symptoms, Eczema Area and Severity Index scores (EASI), Patient-Oriented Eczema Measure (POEM), and Dermatology Life Quality Index (DLQI) questionnaire scores. Results: The symptoms such as itching, popular eruption, hyperpigmentation, hypopigmentation, and exudation gradually decreased and showed a significant improvement at the end of the study. The EASI, POEM, and DLQI showed statistically significant improvement. Conclusion: Ayurveda compound formulations, PTG and GKM, were found clinically safe and effective in the management of Vicharchika (atopic eczema).

Hand eczema and its severity in nonmedical personnel: A study of the use of hand sanitizer on transepidermal water loss and skin capacitance

Abstract Background: An increased frequency of hand sanitizer use and washing hands with soap seems to increase the incidence of hand eczema (HE). Objectives: The aim was to analyze HE in nonmedical personnel, its severity, and the effect of hand sanitizer use on transepidermal water loss (TEWL) and skin capacitance. Methods: This observational cross-sectional study was conducted from July to September 2022. Subjects were recruited based on the study criteria with cluster random sampling method. Each subject’s identity, data related to hand sanitizer use and handwashing, atopic stigmata, and duration of HE were documented. The severity of HE was assessed with the HE Severity Index (HECSI). TEWL and skin capacitance were measured with the Tewameter® TM 300 and Corneometer® CM 825 instruments. Results: Out of 240 subjects who were selected randomly, 24 normal subjects and 24 subjects with HE were recruited. The incidence of HE in nonmedical personnel using hand sanitizer was 10%, with a median disease duration of 22 weeks and a mean HECSI score of 9.25 ± 6.33. There was no significant difference in TEWL and skin capacitance between the groups (P &gt; 0.05). There was no significant correlation between TEWL and skin capacitance with the HECSI score (P &gt; 0.05). Subjects with HE washed their hands more frequently than subjects without HE (6 vs. 4.5 times per day; P 0.005). Conclusion: Most nonmedical personnel with HE had a mild form of the condition. There were no significant barrier function and skin hydration differences between the groups.

Impact of Hand Hygiene and Mask-Wearing Practices on Hand Eczema and Facial Acne Incidence in Healthcare Workers during COVID-19 Outbreak.

Impact of Hand Hygiene and Mask-Wearing Practices on Hand Eczema and Facial Acne Incidence in Healthcare Workers during COVID-19 Outbreak.

Systemic Management of Atopic Dermatitis: New and Emerging Therapies

Atopic dermatitis, also known as atopic eczema (hereafter referred to as eczema) is the most common chronic inflammatory skin disease worldwide and, together with associated allergies, asthma, allergic rhinitis (with or without nasal polyposis), and eosinophilic esophagitis, atopic disorders represent a growing source of patient morbidity and health care cost globally. The incidence of eczema spans all age groups, but in over 80% of cases it manifests during infancy or early childhood; interestingly, there is now recognition that a significant number of patients suffer from adult-onset, chronic-persistent, and/or late-relapsing disease. Eczema is a complex disease with extreme heterogeneity, including highly variable penetrance, clinical phenotypic presentations (ethnicity, age and temporal factors), and natural history across the lifespan. The term endotype has been introduced to describe potential variance in therapeutic responsiveness and etiology, particularly with respect to genetic and immunologic profiling, as well as environmental triggering. Notably, the range of treatment options available for patients with atopic disorders is changing rapidly, especially for eczema. In this review, we provide a brief overview of targeted systemic therapeutic options for patients with eczema and atopy.