Support for 2 variants of eczema

J Allergy Clin Immunol. 2005 Nov;116(5):1067-72. doi: 10.1016/j.jaci.2005.06.038.


Background: Studies investigating the natural history and risk factors for eczema have historically considered eczema as a single entity, without regard for the individual's atopic status. The association between atopy and eczema is complex, and as many as (2/3) of patients with eczema are not atopic.

Objective: To investigate the risk factors for eczema in relation to the child's atopic status in a cohort of high-risk children.

Methods: A prospective birth cohort of 263 children was followed for 5 years and closely examined for eczema. Antenatal and postnatal data on environmental exposures were collected by interview. Skin prick test to define atopic status was performed at 6 months and 2 and 5 years of age.

Results: Of the subjects, 66.1% had eczema in the first 5 years, and the majority (85.5%) reported onset of rash in the first year. A third of those with eczema were not atopic (nonatopic/intrinsic eczema). Children with atopic eczema (extrinsic eczema) were more likely to be male, to have been breast-fed longer, and to have a history of food allergies, allergic rhinitis, and current wheeze. Nonatopic eczema was more common in girls, and an association was found with early daycare attendance.

Conclusion: This study supports the presence of 2 variants of eczema: atopic eczema occurring early in childhood and nonatopic eczema with early daycare attendance. It is likely that environmental factors have a different effect on these 2 variants of eczema, and future studies should thus consider eczema as 2 variants in determining the effect of attributable risks.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • Age of Onset
  • Aging
  • Child Day Care Centers
  • Cohort Studies
  • Dermatitis, Atopic / epidemiology
  • Dermatitis, Atopic / etiology*
  • Eczema / epidemiology
  • Eczema / etiology*
  • Female
  • Humans
  • Hypersensitivity / diagnosis
  • Infant
  • Longitudinal Studies
  • Male
  • Prospective Studies
  • Risk Factors
  • Sex Distribution
  • Skin Tests