Environmental and genetic risk factors of eczema phenotypes. (1st December 2019)

• Record Type: Journal Article
• Authors: Hu, C.; Duijts, L.; Erler, N.S.; Elbert, N.J.; Piketty, C.; Bourdès, V.; Blanchet‐Réthoré, S.; de Jongste, J.C.; Pasmans, S.G.M.A.; Felix, J.F.; Nijsten, T.
• Is Part Of: British journal of dermatology. Volume 181:Number 6(2019)
• Page Start: e155
• Page End: e155
• Publication Date: 2019-12-01
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.18575
• Languages: English
• ISSNs: 0007-0963

Abstract

Summary: Eczema is an itchy skin disease affecting up to 25% of children worldwide and is variable in onset (when it starts) and persistence (how long it lasts for). There is a need to define more detailed eczema types, called phenotypes, to better predict each type's natural course and understand its specific underlying risk factors. Subsequently, the onset and worsening of eczema could be prevented. In a population‐based Dutch group of 5, 297 multi‐ethnic children, five eczema phenotypes were identified based on their probability, taking into account the age of onset and course of eczema between birth and the age of 10 years. The identified eczema phenotypes were never (76%), early transient (8%), mid‐transient (6%), late transient (8%) and persistent eczema (2%). Children with early, mid‐ and late transient eczema had a high probability of developing eczema before the age of 2 years, around the age of 2 years and 5 years, respectively, after which the eczema gradually disappeared. Children with persistent eczema had a high probability of eczema from birth until the age of 10 years. The eczema phenotypes model seemed valid for a multi‐ethnic population in an ever‐globalizing world. Previously known eczema risk factors (including socio‐economic, lifestyle, or genetic factors related to skin barrier defects and immune system) differentiated to a limited degree between the different phenotypes. Early transient eczema was most common in males only. Children with late transient or persistent eczema were more often of Asian and African ethnicity. Therefore, sex and ethnicity could be useful for prediction purposes. Further studies, ideally in a 'hypothesis free approach', are needed to identify other possible predictive factors for the development of eczema phenotypes, in order to improve eczema management and prevention strategies.