Eczema risk factor

The genetic predisposition is a strong risk factor for eczema. If one parent has a positive history of eczema the risk for the offspring is estimated to be between odds ratio 3.4 (95% confidence interval 2.6-4.4) [148(IIa)] and odds ratio 6.2 (95% confidence interval 3.3-11.5) [146(111)]. Usually eczema develops early in life. A study of 1,200 hospital cases suggests that the disease is present in 57% before the age of 1 year and in 87% before the age of 6 years [ 149(IIb)]. Not all patients are affected by eczema throughout their life upon re-examination 13-25 years after the first examination, 44—83% still had eczema [146(111), 147(111), 150(111), 151(IIb)]. 

Early signs of an allergic disease, especially atopic eczema, and presence of IgE antibodies to inhalant allergens are important risk factors for later respiratory allergy. IgE antibodies in infant serum to basic food proteins, e.g. hen s egg, may predict the so-called allergic march. 

Atopic eczema (AE) in childhood seems to be a risk factor for HE in adults (Lammintausta and Kalimo 1981 Rystedt 1985). However, theses studies also found that a considerable number of subjects with a personal history of AE managed to work in risk occupations without developing HE. Therefore a reduced resistance to irritants does not occur in all subjects with AE and... 

Berndt U, Hinnen U, Iliev D, Eisner P (1999) Risk factors for hand eczema in metal worker trainees (in German). Allergologie 22 195... 

Mozzanica N (1992) Pathogenetic aspects of allergic and irritant contact dermatitis. Clin Dermatol 10 115-121 Nilsson E (1986) Individual and environmental risk factors for hand eczema in hospital workers. Acta Derm Venereol Suppl (Stockh) 128 1-63... 

One of the major risk factors is a history of AD. The possibility of hand eczema occurring later in life increases significantly if the AD was severe during childhood and was localised in the hands (60-90% of these patients and 40% of patients with moderate AD develop hand eczema later in working life). The risk of hand dermatitis decreases if the AD was mild. The risk of developing hand dermatitis has been estimated to be threefold in atopic relative to non-atopic workers if there is exposure to skin-irritating factors. Episodes of hand eczema can occur in patients predisposed to AD, even if they are not in working life or are just in clean, dry office work. 

Hand eczema and contact allergy was studied in hospital employees in Finland (Lammintausta et al. 1982). Nickel allergy was found in 9.1% of the 536 workers tested and 60% of all nickel-sensitive persons had a history of hand eczema (Table 3). The 20-month prevalence of hand eczema was 41% among 1857 women employed in wet hospital work in Sweden (Table 3), and the most important risk factors were a history of earlier hand eczema, followed by a history of metal dermatitis (Nilsson and Back 1986). 

Avnstorp C (1991) Risk factors for cement eczema. Contact Dermatitis 25 81-88... 

Nater JP, de Groot AC (1985) Unwanted effects of cosmetics and drugs used in dermatology, 2nd edn. Elsevier, Amsterdam Nilsson E, Mikaelsson B, Andersson S (1985) Atopy, occupational and domestic work as risk factors for hand eczema in hospital workers. Contact Dermatitis 13 216-223 Nutter AF (1979) Contact urticaria to rubber. Br J Dermatol 101 597-598... 

Bergmann RL, Diepgen TL, Kuss O, Bergmann KE, Kujat J, Dudenhausen JW, Wahn U. 2002. Breastfeeding duration is a risk factor for atopic eczema. Clin Exp Allergy 32 205-209. 

Approximately 17% of the U.S. population suffers from some sort of allergic disease (76). Most of those individuals are hypersensitive to pollens or have atopic eczema. Six percent of the population has physician-diagnosed asthma, the prevalence of which has increased by approximately 30% over the last 15 years. Air pollution exposure has long been considered a risk factor for the exacerbation of asthma attacks in asthmatic individuals. Health care statistics in Canada and the United States show that hospital admissions for asthma increase dur-... 

Breaches in the integrity of the skin (eczema, trauma or burns) are predisposing factors for infection. Lymphoedema represents a risk for erysipelas. Open complicated fractures are often complicated by chronic osteomyelitis. Patients with diabetes mel-lims have more frequent as well as more severe infections of the skin, soft tissue and of bone. Sickle cell disease predisposes to osteomyelitis. 

The contribution of genetic factors to the development of IgE sensitisation and to the family history of an IgE-mediated disease is between 70-80%. The risk of developing asthma, rhinitis or eczema in general is related to a family history of the respective disease. 

The increased risk of hand eczema seems to depend on multiple factors. Exposure to common irritating factors, wet work, detergents, chemicals, dirt and mechanical friction are the most common causes for the development of hand eczema at work. Exposure to airborne allergens or irritants can also lead to dermatitis. In addition, working at jobs in which there are changes in temperature and humidity or working in ways that lead to extensive sweating increase risk of dermatitis. 

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