Further Product Information

CONTENTS

Summary
Introduction
Symptoms
Pathophysiology
Diagnosis
Epidemiology
Aetiology
Treatment
Socioeconomic impact
Key points
References

SUMMARY

Atopic eczema is a chronic skin condition that presents predominantly in childhood, affecting 10-20% of school children in developed countries. The majority of cases are associated with atopy which is associated with an elevation of serum immunoglobulin E (IgE) concentrations as a result of the abnormal production of IgE antibodies in response to common environmental allergens. Symptoms of atopic eczema consist principally of dry skin and an itchy rash, often with flexural involvement, and a characteristic distribution pattern that varies with the age of the patient. Commonly, the disease first presents during early infancy and childhood but can persist into adulthood in a small proportion of patients. Atopic eczema is strongly associated with the other atopic diseases (e.g. allergic rhinitis and asthma - the so-called atopic triad), and there is some suggestion that eczema may be a precursor to the development of these other atopic conditions in later life. The clinical emergence of atopic eczema results from a combination of genetic and environmental factors. The disease is associated with higher socioeconomic class and is encountered more frequently in urban settings. The prevalence of atopic eczema has rapidly increased in recent years, particularly in the UK, Scandinavia and Japan. The ‘hygiene hypothesis’ relates the increased prevalence in atopic disease to reduced exposure to microbial allergens and the widespread increase in the use of antibiotics. The condition places a substantial economic burden on healthcare resources, whilst an individual patient’s quality of life is severely compromised by the condition. Current pharmacological treatments, such as the use of emollient creams and topical corticosteroids are largely effective in relieving symptoms. However, prolonged use of more potent topical corticosteroids is not recommended in view of the potential for local and systemic side-effects.

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