Long term follow-up in atopic dermatitis

A long-term follow-up study (minimum 24 years) has been carried out on 955 individuals with a history of atopic dermatitis (AD), who in childhood had been in- or out-patients at the Department of Dermatology, Karolinska Hospital, Stockholm. 62% of the in-patients and 40% of the out-patients still had dermatitis at investigation. The most common site was the hands. Eczematous hand involvement in childhood had been of predominant importance for the occurrence of hand eczema in adult life. Both tabular and stepwise logistic regression analyses revealed that the prognostically unfavorable factors as regards healing were, in order of importance, severe (widespread) dermatitis in childhood, family history of AD, associated allergic rhinitis, and/or bronchial asthma (with allergic rhinitis as the dominant of these two factors), female sex and early age at onset. Fewer than 20% of the individuals with all these prognostic factors were healed at the time of investigation, whereas 85% of those with none of the factors were healed. Persistent dry/itchy skin in adulthood was also found to be associated with persistent or recurring AD to a significantly (p less than 0.001) higher degree than normal skin. As this factor cannot be used as a predictor in childhood, it was not included in the regression analyses.