Eczema natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Edzel Lorraine Co, D.M.D., M.D.
Overview
Eczema has regarded as a medical condition with a natural history that occurs consistently. It is characterized as a disease with an early onset, mostly during the childhood period, and remits during the adolescence period. If eczema is left untreated, it can lead to viral, bacterial and fungal infections. Psychological problems could also arise brought about by constant itching.
Eczema Natural History, Complications, and Prognosis
Natural History
- Eczema has regarded as a medical condition with a natural history that occurs consistently.
- It is characterized as a disease with an early onset, mostly during the childhood period, and remits during the adolescence period. [1]
Comorbidities
- Individuals suffering from eczema often have comorbidities like asthma [2], allergic rhinitis [3], contact dermatitis [4], food allergy, [5] and atopy-associated eye diseases.[6]
- Peanut allergy is the most common form of food allergy associated with eczema. [5]
- The National Institute of Allergy and Infectious Diseases 2017 guidelines recommend that all infants suffering from severe eczema should undergo skin prick testing or peanut-specific IgE evaluation to assess for possible occurrence of peanut allergy and be prevented as early as possible. [7]
- Eczema is also associated with metabolic problems such as obesity. [8]
Complications
- Eczema can lead to viral, bacterial and fungal infections.
- Psychological problems could also arise brought about by constant itching.
- 92,642 children participants with eczema in a cross-sectional study were observed to have a two-fold increase in having an attention deficit hyperactivity disorder (ADHD). [9] [10]
- A higher incidence rate of anxiety disorders in adolescence is observed. These include generalized anxiety disorder and social anxiety disorder.
- The elderly people with eczema are the most commonly affected with depression. [11]
Prognosis
- In those patients who have an onset of eczema during their first two years of life, a higher remission rate is expected than those who have a later onset of disease. [12]
- Hand eczema has poor prognosis with accounted 44% manifestation of symptoms in a 15-year follow-up study. [13]
- In another study, complete healing was only observed among 19.3% of the patients after a 5-year follow-up. [14]
References
- ↑ Paternoster L, Savenije OEM, Heron J, Evans DM, Vonk JM, Brunekreef B; et al. (2018). "Identification of atopic dermatitis subgroups in children from 2 longitudinal birth cohorts". J Allergy Clin Immunol. 141 (3): 964–971. doi:10.1016/j.jaci.2017.09.044. PMC 5840507. PMID 29129583.
- ↑ Holgate ST (2007). "The epithelium takes centre stage in asthma and atopic dermatitis". Trends Immunol. 28 (6): 248–51. doi:10.1016/j.it.2007.04.007. PMID 17466594.
- ↑ Zheng T, Yu J, Oh MH, Zhu Z (2011). "The atopic march: progression from atopic dermatitis to allergic rhinitis and asthma". Allergy Asthma Immunol Res. 3 (2): 67–73. doi:10.4168/aair.2011.3.2.67. PMC 3062798. PMID 21461244.
- ↑ de Groot AC (1990). "The frequency of contact allergy in atopic patients with dermatitis". Contact Dermatitis. 22 (5): 273–7. doi:10.1111/j.1600-0536.1990.tb01595.x. PMID 2383986.
- ↑ 5.0 5.1 Jackson PG, Lessof MH, Baker RW, Ferrett J, MacDonald DM (1981). "Intestinal permeability in patients with eczema and food allergy". Lancet. 1 (8233): 1285–6. doi:10.1016/s0140-6736(81)92459-4. PMID 6112605.
- ↑ Kulthanan K, Tuchinda P, Nitiyarom R, Chunharas A, Chantaphakul H, Aunhachoke K; et al. (2021). "Clinical practice guidelines for the diagnosis and management of atopic dermatitis". Asian Pac J Allergy Immunol. 39 (3): 145–155. doi:10.12932/AP-010221-1050. PMID 34246205 Check
|pmid=value (help). - ↑ Togias A, Cooper SF, Acebal ML, Assa'ad A, Baker JR, Beck LA; et al. (2017). "Addendum Guidelines for the Prevention of Peanut Allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases-Sponsored Expert Panel". J Pediatr Nurs. 32: 91–98. doi:10.1016/j.pedn.2016.12.006. PMID 28137368.
- ↑ Silverberg JI, Kleiman E, Lev-Tov H, Silverberg NB, Durkin HG, Joks R; et al. (2011). "Association between obesity and atopic dermatitis in childhood: a case-control study". J Allergy Clin Immunol. 127 (5): 1180–6.e1. doi:10.1016/j.jaci.2011.01.063. PMID 21411132.
- ↑ Yaghmaie P, Koudelka CW, Simpson EL (2013). "Mental health comorbidity in patients with atopic dermatitis". J Allergy Clin Immunol. 131 (2): 428–33. doi:10.1016/j.jaci.2012.10.041. PMC 3565469. PMID 23245818.
- ↑ Buske-Kirschbaum A, Schmitt J, Plessow F, Romanos M, Weidinger S, Roessner V (2013). "Psychoendocrine and psychoneuroimmunological mechanisms in the comorbidity of atopic eczema and attention deficit/hyperactivity disorder". Psychoneuroendocrinology. 38 (1): 12–23. doi:10.1016/j.psyneuen.2012.09.017. PMID 23141851.
- ↑ Nicholas MN, Gooderham MJ (2017). "Atopic Dermatitis, Depression, and Suicidality". J Cutan Med Surg. 21 (3): 237–242. doi:10.1177/1203475416685078. PMID 28300443.
- ↑ Kim JP, Chao LX, Simpson EL, Silverberg JI (2016). "Persistence of atopic dermatitis (AD): A systematic review and meta-analysis". J Am Acad Dermatol. 75 (4): 681–687.e11. doi:10.1016/j.jaad.2016.05.028. PMC 5216177. PMID 27544489.
- ↑ Meding B, Wrangsjö K, Järvholm B (2005). "Fifteen-year follow-up of hand eczema: persistence and consequences". Br J Dermatol. 152 (5): 975–80. doi:10.1111/j.1365-2133.2005.06494.x. PMID 15888155.
- ↑ Olesen CM, Agner T, Ebbehøj NE, Carøe TK (2019). "Factors influencing prognosis for occupational hand eczema: new trends". Br J Dermatol. 181 (6): 1280–1286. doi:10.1111/bjd.17870. PMID 30851194.