Comparison of prevalence of atopic dermatitis in Japanese elementary schoolchildren between 2001/2002 and 2007/2008

A Comprehensive Review of the Treatment of Atopic Eczema

Atopic eczema (AE) is a chronic, inflammatory skin disorder which usually develops in early childhood. In spite of intensive investigations, the causes of AE remain unclear, but are likely to be multifactorial in nature. Environmental factors or genetic-environmental interactions seem to play a key role in disease progression. Among various measures of AE managment, cutaneous hydration, which improves barrier function and relieve itchiness, may be helpful to reduce the need for topical steroid use and therefore should be used as a basic treatment. Avoiding aggravating factors is also a basic treatment of AE. Standard medical treatment with a pharmacologic approach may be necessary if basic treatment fails to control symptoms satisfactorily. Recently, more attention is given to a proactive therapeutic by regular intermittent application of low potency steroids or topical calcineurin inhibitors to prevent new flares. Furthermore, various targeted biologics are being introduced for AE control and are proposed as promising therapies. This paper provides a summary of the recent literature on the manangement of AE and a treatment guideline.

Indoor total volatile organic compounds exposure at 6 months followed by atopic dermatitis at 3 years in children

BACKGROUND

Exposure to indoor air pollutants is thought to cause allergic inflammation. Volatile organic compounds (VOCs) are one of the aggravating factors of asthma and other allergic diseases. However, the influence of VOCs on development of atopic dermatitis is ambiguous in the clinical field. We therefore investigated the associations of indoor total volatile organic compounds (TVOCs) and development of atopic dermatitis in young Korean children.

METHODS

From the birth cohort of a MOthers and Children's Environmental Health (MOCEH) study, 257 infants, whose parents agreed with the environmental measurement, were enrolled. Total VOCs were measured in infant's bedrooms at the age of 6 month. A total of 105 parents answered a questionnaire at 36 month. Concentrations of TVOCs were divided into two groups by third quartile (75th). Associations between the high VOCs exposure group and development of atopic dermatitis at the age of 36 months were estimated by multivariate logistic regression.

RESULTS

The average concentration of TVOCs was 174.7 ± 115.1 ㎍/m(3) . We defined the high TVOCs exposure group by those with more than 75 percentile of the distribution (242.1 ㎍/m(3) ). An increased risk of atopic dermatitis was observed in the high TVOCs exposure group, after adjustment for parents history of allergy, household income, breast-feeding longer than 6 month (OR = 3.116, 95% Cl 1.041-9.323). Risk of atopic dermatitis was increased when the family bought new furniture within 1 yr.

CONCLUSION

Our results showed that exposure to high concentration of VOCs during infancy, an indoor pollutant, increased the risk of atopic dermatitis at 36 months.

Investigating international time trends in the incidence and prevalence of atopic eczema 1990-2010: a systematic review of epidemiological studies

The prevalence of atopic eczema has been found to have increased greatly in some parts of the world. Building on a systematic review of global disease trends in asthma, our objective was to study trends in incidence and prevalence of atopic eczema. Disease trends are important for health service planning and for generating hypotheses regarding the aetiology of chronic disorders. We conducted a systematic search for high quality reports of cohort, repeated cross-sectional and routine healthcare database-based studies in seven electronic databases. Studies were required to report on at least two measures of the incidence and/or prevalence of atopic eczema between 1990 and 2010 and needed to use comparable methods at all assessment points. We retrieved 2,464 citations, from which we included 69 reports. Assessing global trends was complicated by the use of a range of outcome measures across studies and possible changes in diagnostic criteria over time. Notwithstanding these difficulties, there was evidence suggesting that the prevalence of atopic eczema was increasing in Africa, eastern Asia, western Europe and parts of northern Europe (i.e. the UK). No clear trends were identified in other regions. There was inadequate study coverage worldwide, particularly for repeated measures of atopic eczema incidence. Further epidemiological work is needed to investigate trends in what is now one of the most common long-term disorders globally. A range of relevant measures of incidence and prevalence, careful use of definitions and description of diagnostic criteria, improved study design, more comprehensive reporting and appropriate interpretation of these data are all essential to ensure that this important field of epidemiological enquiry progresses in a scientifically robust manner.