EPIDEMIOLOGY OF ATOPIC ECZEMA

The atopic eczema constitutes the most frequent inflammatory skin dise ase in childhood. The disease is best assessed by a clinical diagnosis of a physician who is experienced in skin diseases. For epidemiologic purposes in the UK, easy to use and valid diagnostic criteria have be en developed. Several studies proved a significant increase in western industrialized countries over the past decades. Comparable studies ar e not available for Germany so far. Taking German studies into conside ration which rely on an actual dermatological examination the prevalen ce of atopic eczema can be estimated with 3% for adults and 12% for pr eschool children, with girls being more frequently affected. The atopi c eczema is characterized by an early onset (57 - 73% before first yea r of live), a cyclic course, and a spontaneous remission in some patie nts during adulthood (17 - 56%). 48 - 65% of the patients notice an im provement during summer months and 10 - 30% report a worsening by cert ain food. Psychological moods can influence the skin condition in abou t 35.5% of the affected patients. Besides the genetic predisposition s everal external risk factors have been identified by epidemiologic stu dies. These include the socioeconomic status and exposure to aeroaller gens, especially house dust mite and pets (rodents). Air pollutants ca n also influence the manifestation of the eczema. According to the cor responding studies this is true for tobacco smoke (also during pregnan cy), indoor NOx, and traffic-related emissions. In addition comparativ e studies in East and West Germany showed a significantly increased pr evalence of eczema in East Germany. Although these results contribute to the better understanding of the multifactorial genesis of the atopi c eczema, the reasons for its increase are not clarified yet.