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

ABSTRACT

BACKGROUND: 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. OBJECTIVES: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.