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. ^[1] 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], and food allergy ^[5].

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). ^[6] ^[7]
- A higher incidence rate of anxiety disorders in adolescence is observed. These include generalized anxiety disorder and social anxiety disorder. ^[8]
- The elderly people with eczema are the most commonly affected with depression. ^[8]
Table 1 presents the associated comorbidities and complications of eczema.

**Table 1. Associated comorbidities and complications of eczema.**
Complications	Description

Bacterial Infections	Staphylococcus aureus^[9]^[10] and Methicillin-resistant S. aureus colonization. ^[11] ^[12] ^[13]
Viral Infections	Eczema herpeticum ^[14], herpes simplex virus ^[15], and Molluscum contagiosum ^[16].
Fungal Infections	Tinea ^[15]
Psychological	Attention-deficit/Hyperactivity Disorder (ADHD) and speech disorders. ^[17] ^[18]

Prognosis

Hand eczema has poor prognosis with accounted 44% manifestation of symptoms in a 15-year follow-up study. ^[19]
In another study, complete healing was only observed among 19.3% of the patients after a 5-year follow-up. ^[20]

References

↑ ^1.0 ^1.1 Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID https://doi.org/10.1016/j.jaci.2017.09.044 Check |pmid= value (help).
↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID https://doi.org/10.1016/j.it.2007.04.007 Check |pmid= value (help).
↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID https://doi.org/10.4168/aair.2011.3.2.67 Check |pmid= value (help).
↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID https://doi.org/10.1111/j.1600-0536.1990.tb01595.x Check |pmid= value (help).
↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID https://doi.org/10.1016/S0140-6736(81)92459-4 Check |pmid= value (help).
↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID https://doi.org/10.1016/j.jaci.2012.10.041 Check |pmid= value (help).
↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID https://doi.org/10.1016/j.psyneuen.2012.09.017 Check |pmid= value (help).
↑ ^8.0 ^8.1 Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID https://doi.org/10.1177/1203475416685078 Check |pmid= value (help).
↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID 10.1016/j.cyto.2014.11.023. doi: 10.1016/j.cyto.2014.11.023. Check |pmid= value (help).
↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID 10.2500/aap.2017.38.4005. doi: 10.2500/aap.2017.38.4005. Check |pmid= value (help).
↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID 10.1111/j.1365-2133.2008.08905.x. doi: 10.1111/j.1365-2133.2008.08905.x. Check |pmid= value (help).
↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID 10.1111/j.1365-2133.2010.09679.x. doi: 10.1111/j.1365-2133.2010.09679.x. Check |pmid= value (help).
↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID 10.1007/s12016-016-8548-5. doi: 10.1007/s12016-016-8548-5. Check |pmid= value (help).
↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID 10.1038/sj.jid.5700657. doi: 10.1038/sj.jid.5700657. Check |pmid= value (help).
↑ ^15.0 ^15.1 Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID 10.3390/jcm4050884. doi: 10.3390/jcm4050884. Check |pmid= value (help).
↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID http://dx.doi.org/10.1016/j.cpha.2016.06.004. Check |pmid= value (help).
↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID 10.1111/bjd.14697. doi: 10.1111/bjd.14697. Check |pmid= value (help).
↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID 10.1016/j.jpeds.2015.09.066. doi: 10.1016/j.jpeds.2015.09.066. Check |pmid= value (help).
↑ 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.

[pmidhttps://doi.org/10.1016/j.jaci.2017.09.044-1] 1.0 ^1.1 Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID https://doi.org/10.1016/j.jaci.2017.09.044 Check |pmid= value (help).

[pmidhttps://doi.org/10.1016/j.it.2007.04.007-2] Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID https://doi.org/10.1016/j.it.2007.04.007 Check |pmid= value (help).

[pmidhttps://doi.org/10.4168/aair.2011.3.2.67-3] Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID https://doi.org/10.4168/aair.2011.3.2.67 Check |pmid= value (help).

[pmidhttps://doi.org/10.1111/j.1600-0536.1990.tb01595.x-4] Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID https://doi.org/10.1111/j.1600-0536.1990.tb01595.x Check |pmid= value (help).

[pmidhttps://doi.org/10.1016/S0140-6736(81)92459-4-5] Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID https://doi.org/10.1016/S0140-6736(81)92459-4 Check |pmid= value (help).

[pmidhttps://doi.org/10.1016/j.jaci.2012.10.041-6] Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID https://doi.org/10.1016/j.jaci.2012.10.041 Check |pmid= value (help).

[pmidhttps://doi.org/10.1016/j.psyneuen.2012.09.017-7] Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID https://doi.org/10.1016/j.psyneuen.2012.09.017 Check |pmid= value (help).

[pmidhttps://doi.org/10.1177/1203475416685078-8] 8.0 ^8.1 Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID https://doi.org/10.1177/1203475416685078 Check |pmid= value (help).

[pmiddoi:_10.1016/j.cyto.2014.11.023.-9] Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID 10.1016/j.cyto.2014.11.023. doi: 10.1016/j.cyto.2014.11.023. Check |pmid= value (help).

[pmiddoi:_10.2500/aap.2017.38.4005.-10] Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID 10.2500/aap.2017.38.4005. doi: 10.2500/aap.2017.38.4005. Check |pmid= value (help).

[pmiddoi:_10.1111/j.1365-2133.2008.08905.x.-11] Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID 10.1111/j.1365-2133.2008.08905.x. doi: 10.1111/j.1365-2133.2008.08905.x. Check |pmid= value (help).

[pmiddoi:_10.1111/j.1365-2133.2010.09679.x.-12] Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID 10.1111/j.1365-2133.2010.09679.x. doi: 10.1111/j.1365-2133.2010.09679.x. Check |pmid= value (help).

[pmiddoi:_10.1007/s12016-016-8548-5.-13] Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID 10.1007/s12016-016-8548-5. doi: 10.1007/s12016-016-8548-5. Check |pmid= value (help).

[pmiddoi:_10.1038/sj.jid.5700657.-14] Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID 10.1038/sj.jid.5700657. doi: 10.1038/sj.jid.5700657. Check |pmid= value (help).

[pmiddoi:_10.3390/jcm4050884.-15] 15.0 ^15.1 Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID 10.3390/jcm4050884. doi: 10.3390/jcm4050884. Check |pmid= value (help).

[pmidhttp://dx.doi.org/10.1016/j.cpha.2016.06.004.-16] Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID http://dx.doi.org/10.1016/j.cpha.2016.06.004. Check |pmid= value (help).

[pmiddoi:_10.1111/bjd.14697.-17] Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID 10.1111/bjd.14697. doi: 10.1111/bjd.14697. Check |pmid= value (help).

[pmiddoi:_10.1016/j.jpeds.2015.09.066.-18] Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID 10.1016/j.jpeds.2015.09.066. doi: 10.1016/j.jpeds.2015.09.066. Check |pmid= value (help).

[pmid15888155-19] 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.

[pmid30851194-20] 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.

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