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Clinical onset of atopic eczema: Results from two nationally representative British birth cohorts followed through mid-life

Research output: Contribution to journalArticle

Original languageEnglish
JournalJournal of Allergy and Clinical Immunology
Early online date28 Jun 2019
DateAccepted/In press - 31 May 2019
DateE-pub ahead of print (current) - 28 Jun 2019


BACKGROUND: Atopic eczema onset is described primarily in early childhood; the frequency and characteristics of adult-onset disease remain controversial.

OBJECTIVE: To determine the proportion of individuals who report atopic eczema symptoms between birth and mid adulthood, and to examine demographic, immunologic, and genetic factors associated with period of symptom onset.

METHODS: We conducted a longitudinal study using data from two nationally representative community-based birth cohorts from the United Kingdom: the British Cohort Studies 1958 and 1970. Individuals were followed from birth through age 42-50. The primary outcome was the age period of self-reported atopic eczema symptom onset based on repeated measures of self-reported atopic eczema at each survey wave.

RESULTS: The annual period prevalence of atopic eczema ranged from 5-15% in two cohorts of over 17,000 participants each followed from birth through mid-age. There was no clear trend in prevalence by age, and among adults reporting active atopic eczema during a given year, only 38% had symptom onset reported in childhood. When compared with individuals whose eczema started in childhood, those with adult-onset disease were more likely to be women, from Scotland or Northern England, of lower childhood socio-economic group, smokers in adulthood, and less likely to have a history of asthma. In a sub-analysis using data from the 1958 cohort only, genetic mutations previously associated with atopic eczema, including filaggrin null mutations, and allergen-specific IgE were more common among those with childhood-onset disease.

CONCLUSION: Rates of self-reported atopic eczema remain high after childhood, and adult-onset atopic eczema has different risk factor associations than childhood-onset eczema.

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Copyright © 2019. Published by Elsevier Inc.


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