Eczema

TY - JOUR

T1 - Eczema

AU - Schmitt, Jochen

AU - Apfelbacher, Christian J

AU - Flohr, Carsten

PY - 2011/5

Y1 - 2011/5

N2 - As defined by the World Allergy Organization (WAO) revised nomenclature in 2003, eczema (also known as atopic dermatitis)[1] is a chronic, relapsing, and itchy inflammatory skin condition. In the acute stage, eczematous lesions are characterised by poorly defined erythema with surface change (oedema, vesicles, and weeping). In the chronic stage, lesions are marked by skin thickening (lichenification). Although lesions can occur anywhere on the body, infants often have eczematous lesions on their cheeks and outer limbs before they develop eczema in the typical flexural areas such as behind the knees and in the folds of the elbow and neck. About 50% of people suffering from eczema also become sensitised to environmental allergens, such as house dust mite, and may then be classified as having atopic eczema under the revised WAO nomenclature.[2] Diagnosis: There is no definitive diagnostic "gold standard" for diagnosing eczema. However, a UK Working Party developed a minimum list of validated diagnostic criteria for eczema using the Hanifin and Rajka list of clinical features as building blocks (see table 1).[3] The criteria were shown to have a sensitivity of 85% and a specificity of 96% in children when compared with a dermatologist's diagnosis.[3] Although there are a large number of eczema severity scores for eczema in the public domain, only the SCORing Atopic Dermatitis (SCORAD) index, the Eczema Area Severity Index (EASI), the Patient Oriented Eczema Measure (POEM), and the Six Area, Six Sign Atopic Dermatitis severity index (SASSAD) have been shown to have adequate validity and reliability (see table 2 for full details). Population: For the purposes of this review, we included all adults and children defined as having established eczema. Where adults or children are considered separately, this is highlighted in the text. We also included studies assessing primary prevention of eczema using specific interventions: prolonged breastfeeding, maternal dietary restriction, house dust mite restriction, and early introduction of probiotics.

AB - As defined by the World Allergy Organization (WAO) revised nomenclature in 2003, eczema (also known as atopic dermatitis)[1] is a chronic, relapsing, and itchy inflammatory skin condition. In the acute stage, eczematous lesions are characterised by poorly defined erythema with surface change (oedema, vesicles, and weeping). In the chronic stage, lesions are marked by skin thickening (lichenification). Although lesions can occur anywhere on the body, infants often have eczematous lesions on their cheeks and outer limbs before they develop eczema in the typical flexural areas such as behind the knees and in the folds of the elbow and neck. About 50% of people suffering from eczema also become sensitised to environmental allergens, such as house dust mite, and may then be classified as having atopic eczema under the revised WAO nomenclature.[2] Diagnosis: There is no definitive diagnostic "gold standard" for diagnosing eczema. However, a UK Working Party developed a minimum list of validated diagnostic criteria for eczema using the Hanifin and Rajka list of clinical features as building blocks (see table 1).[3] The criteria were shown to have a sensitivity of 85% and a specificity of 96% in children when compared with a dermatologist's diagnosis.[3] Although there are a large number of eczema severity scores for eczema in the public domain, only the SCORing Atopic Dermatitis (SCORAD) index, the Eczema Area Severity Index (EASI), the Patient Oriented Eczema Measure (POEM), and the Six Area, Six Sign Atopic Dermatitis severity index (SASSAD) have been shown to have adequate validity and reliability (see table 2 for full details). Population: For the purposes of this review, we included all adults and children defined as having established eczema. Where adults or children are considered separately, this is highlighted in the text. We also included studies assessing primary prevention of eczema using specific interventions: prolonged breastfeeding, maternal dietary restriction, house dust mite restriction, and early introduction of probiotics.

M3 - Review article

C2 - 21609512

SN - 1752-8526

VL - 2011

JO - BMJ Clinical Evidence

JF - BMJ Clinical Evidence

M1 - 1716

ER -