Atopic eczema is a very common problem. European prevalence studies done in the last decade suggest an overall prevalence of 15-20% in children aged 7-18 years.7 Standardised questionnaire data from 0.5 million children aged
13-14 years in the International Study of Asthma and Allergies in Childhood (ISAAC) suggest that atopic eczema is not just a problem confined to Western Europe, high prevalence being found in many developing cities undergoing rapid demographic change.8 There is reasonable evidence to suggest that the prevalence of atopic eczema has increased two to threefold over the last 30 years, although the reasons for this are unclear.9 No reliable estimates of incidence are available for atopic eczema.
Atopic eczema is more frequent in childhood, especially in the first 5 years of life. One study of 2365 patients in Livingston, Scotland who were examined by a dermatologist for atopic eczema suggested that atopic eczema is relatively rare over 40 years of age, with a 1-year period prevalence of 0-2%.10 Yet, because there are many more adults than children, they may make up over 38% of all atopic eczema cases in that community. Adults also tend to represent a more persistent and severe subset of cases.
Most cases of childhood eczema in any given community are mild. One recent study found that 84% of 1760 children aged 1-5 years from four urban and semi-urban general practices around Nottingham were mild, as defined globally by the examining physician, with 14% of cases in the moderate category and 2% in the severe category,11 a severity distribution that was very similar to another recent population survey in Norway.12
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