Abstract

This study aimed to estimate the association between eczema in early childhood and the onset of asthma and rhinitis later in life in children.
Methods: The present study was conducted in the department of dermatology and 2000 children were included in the study. A questionnaire based on an International Study of Asthma and Allergies in Childhood (ISAAC) protocol¹⁸ was given to parents of all children aged 1 to 5 years.
Results: There were no differences in background (age and sex) and health factors (prevalence of eczema, asthma, wheezing and rhinitis, and parents with history of allergic disease) measured at baseline between the children participating in both surveys compared with the “drop-outs” (p>0.05). However, there was a higher prevalence of parental smoking (30.5% vs. 22.2%; p<0.001). In adjusted analysis, children with persistence of eczema, early onset of eczema, or moderate to severe eczema had even higher odds of developing asthma and rhinitis than children with eczema in general. The odds of developing asthma and rhinitis was 5-fold in children with persistence of eczema compared with the absence of eczema (aOR, 5.16; 2.62–10.18 and aOR, 4.00; 2.53-6.22, respectively). Early onset of eczema was a strong risk factor for the incidence of asthma (aOR, 3.44; 95% CI, 1.94-6.09) and the incidence of rhinitis (aOR, 4.05; 95% CI, 2.82-5.81) compared with children without eczema, whereas there was no significant association between the late onset of eczema and the incidence of asthma (aOR, 2.07; 0.78-5.49) and rhinitis (aOR, 0.96; 0.45-2.03).
Conclusion: Eczema in infancy is associated with development of asthma and rhinitis during the following 5-year period, and eczema is one of the strongest risk factors. Early identification is valuable for prediction of the atopic march.