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There are steps people can take to reduce or ease flare-ups, experts say

WebMD News from HealthDay

By Mary Elizabeth Dallas

HealthDay Reporter

WEDNESDAY, April 2, 2014 (HealthDay News) -- Many children with eczema will continue to have symptoms of the skin condition as adults, new research suggests.

Although eczema, or "atopic dermatitis," often begins during childhood, the new study found that kids with eczema will likely experience flare-ups into their 20s. In some cases, the researchers added, people could be dealing with the skin ailment throughout their lifetime.

"Based on our findings, it is probable that [eczema] does not fully resolve in most children with mild to moderate symptoms," wrote a team led by Dr. David Margolis at the University of Pennsylvania Perelman School of Medicine. They said that doctors who treat children with mild to moderate forms of eczema should tell the patient and their caregiver that the illness could be lifelong "with periods of waxing and waning skin problems."

One expert said the study gives valuable new insight into the course of the illness.

"Eczema is a skin disease that usually occurs in young children. These patients have sensitive skin, prone to inflammation, infections and allergies," explained Dr. Joshua Zeichner, director of cosmetic and clinical research in the department of dermatology at Mount Sinai Hospital in New York City. "Itching is a hallmark of the disease and it is associated with significant health care costs, impairment of quality of life and interpersonal relationships, and lost time at school and work."

According to Zeichner, "it is generally thought that eczema resolves as young children get older. This study, however, followed the natural course of the disease over long periods of time and discovered that symptoms may persist longer than previously thought, lasting at least into the second decade of life or longer."

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Childhood Eczema Often Persists Into Adulthood, Study Finds

PUBLIC RELEASE DATE:

2-Apr-2014

Contact: Kim Menard Kim.Menard@uphs.upenn.edu 215-662-6183 The JAMA Network Journals

Bottom Line: Children diagnosed with atopic dermatitis (AD or eczema) may have symptoms persist into their 20s, and the condition is likely to be a lifelong illness marked by waxing and waning skin problems.

Author: David J. Margolis, M.D., Ph.D., of the University of Pennsylvania Perelman School of Medicine, Philadelphia, and colleagues.

Background: AD or eczema is a common skin disease that often begins in childhood, but little has been reported about the natural history of the condition.

How the Study Was Conducted: The authors examined the natural history of eczema using self-reported data from a group of 7,157 children enrolled in the Pediatric Eczema Elective Registry (PEER) study to evaluate the prevalence of symptoms over time. The average age of AD onset was 1.7 years.

Results: At every age (i.e. 2 to 26 years) more than 80 percent of the study participants had eczema symptoms or were using medication to treat the condition. During five years of follow-up, 64 percent of patients never reported a six-month period when their skin was symptom free while they were not using topical medications. It was not until age 20 that 50 percent of patients had at least one six-month period free of symptoms and treatment. The authors acknowledge that study participants may have had more severe disease and therefore more persistent eczema.

Discussion: "In conclusion, symptoms associated with AD seem to persist well into the second decade of a child's life and likely longer. Based on our findings, it is probable that AD does not fully resolve in most children with mild to moderate symptoms. Physicians who treat children with mild to moderate AD should tell children and their caregivers that AD is a lifelong illness with periods of waxing and waning skin problems."

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Study suggests symptoms of childhood eczema persist, likely a lifelong illness