Environmental triggers for eczema

To assess the role of various environmental factors on severity of eczema in children, Sinead Langan of the University of Nottingham and colleagues studied 60 children aged 0–15 years with eczema for 6–9 months. Overlapping start dates allowed study of seasonal factors over a full year.

Daily electronic diaries and portable data loggers recorded indoor exposures, and external meteorological data were obtained from a local monitoring centre. The primary measure was a daily ‘bother’ score, recording: ‘How much bother did your (your child’s) eczema cause today?’

Increased eczema ‘bother’ was associated with nylon clothing, dust, unfamiliar pets, sweating and shampoo – the latter was more ‘bothersome’ in cold weather. Nylon clothing specifically increased eczema ‘bother’ on the body and limbs, wool clothing, on the body, and unfamiliar pets, on hands. A combination of any three of seven possible triggers caused the condition to worsen. A linear relationship was observed between each additional exposure and eczema worsening.

The researchers commented that they had found a connection between eczema worsening and irritant exposure, and a specific connection between washing a child’s hair at the same time as the bath or shower and worsening of eczema.

Interactions were also seen between the worsening eczema and cold weather. This may be related to the role of filaggrin mutations in eczema leading to impaired skin barrier function.

British Journal of Dermatology

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October 2009

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