Hand eczema and atopic dermatitis in adolescents: a prospective cohort study from the BAMSE project
Linked Comment: Apfelbacher, Br J Dermatol 2015; 173: 1121–22.
Funding sources:
This study was supported by AFA Insurance; Karolinska Institutet; the Welander–Finsen Foundation; the Swedish Asthma and Allergy Association's Research Foundation; the Foundation for Health Care Sciences and Allergy Research; the Centre for Allergy Research (CfA); the Stockholm County Council; and the Swedish Research Council for Health, Working Life and Welfare.
Conflicts of interest:
None declared.
Summary
Background
There is a well-known association between atopic dermatitis (AD) and hand eczema but less is known about how age at onset, persistence and severity of AD influence the risk of developing hand eczema.
Objectives
To examine the role of AD in the occurrence of hand eczema in adolescence. In addition, associations between asthma and rhinoconjunctivitis, sensitization to common airborne and food allergens, and hand eczema were studied.
Methods
From the population-based birth cohort BAMSE, 2927 adolescents who had been followed up repeatedly concerning allergy-related disease were included. Questionnaires identified adolescents with hand eczema at 16 years, and their blood was analysed for specific IgE.
Results
A total of 152 (5·2%) adolescents had hand eczema at the age of 16 years. Many of these adolescents had a history of AD (n = 111; 73·0%) and asthma and/or rhinitis (n = 83; 54·6%), respectively. Children with AD (aged 0–16 years) had more than threefold increased odds ratios (OR) for having hand eczema; those with persistent or severe AD had a crude OR of 6·1 [95% confidence interval (CI) 4·0–9·1] and 5·3 (95% CI 2·9–9·6), respectively.
Conclusions
We confirm a strong association between AD during childhood and hand eczema in adolescence. Children with persistent or more severe AD are at greater risk of developing hand eczema. Asthma and/or rhinoconjunctivitis, positive specific IgE or age at onset of AD are not associated with hand eczema in adolescence.