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Background: Parents of children with eczema or psoriasis experience high levels of parenting stress, which can negatively impact their child's mental and physical health. Aims: We aimed to investigate the effectiveness, feasibility and acceptability of a mindful parenting intervention for parents of children with eczema or psoriasis. Method: Seven parents of children (4–12 years old) with eczema or psoriasis took part in an 8-week mindful parenting group intervention. A single-case experimental design was adopted, whereby parents completed daily idiographic measures of parenting stress related to their child's skin condition. Parents also completed standardised questionnaires measuring their parenting stress, depression, anxiety and quality of life, and children completed a quality of life measure, at four time points: baseline, pre-intervention, post-intervention and 6-week follow-up. Parents provided qualitative feedback after the intervention. Results: All parents completed the intervention and showed improvements in idiographic measures of parenting stress from baseline to follow-up. Improvements in parenting stress were larger at follow-up than post-intervention, suggesting the benefits of intervention continue beyond the intervention. Six of seven parent–child dyads showed improvement in at least one of the wellbeing measures, from pre-intervention to post-intervention or follow-up. Feasibility was demonstrated through good participant retention, adherence to home practice, and treatment fidelity. Acceptability was demonstrated through positive parent evaluations of the intervention. Conclusions: Mindful parenting can be an effective, feasible and acceptable intervention for parents of children with eczema or psoriasis. Future studies should attempt to replicate the findings through randomised controlled trials. [ABSTRACT FROM AUTHOR]

The quality of indoor environment is a risk factor for early childhood eczema and atopic dermatitis; however, its influence during pregnancy on childhood eczema in Japan has not been investigated. In this study, we aimed to determine the indoor environmental factors that are associated with eczema in children up to 3 years of age, using national birth cohort data from the Japan Environment and Children's Study (JECS). Information on indoor environments and eczema symptoms until 3 years of age was collected using self-administered questionnaires to the mothers. A total of 71,883 and 58,639 mother-child pairs at 1.5- and 3-years-old, respectively, were included in the former analyses. To account for prenatal indoor risk factors, 17,568 (1.5-years-old) and 7063 (3-years-old) children without indoor mold and/or ETS exposure were included in the final analysis. A higher mold index, gas heater use, parquet flooring use, and frequent insecticide use showed significantly increased risks for childhood eczema up to 3 years of age. These associations were consistent after stratification analysis among children whose parents did not have a history of allergies. The updated WHO guidelines on indoor air quality should be implemented based on recent findings regarding the effects of prenatal exposure to indoor dampness on health effects of children further in life, including asthma, respiratory effects, eczema, and other immunological effects. • Determinants of prenatal indoor risk factors on childhood eczema were investigated. • Gas heater, parquet flooring, and insecticide use are risks for childhood eczema. • Mold exposure before infant birth is a risk factor, regardless of parental heredity. • Prenatal mold exposure is a risk factor, regardless of postnatal mold exposure. • Reducing mold during pregnancy may help prevent childhood eczema in early life. [ABSTRACT FROM AUTHOR]

We surveyed 40 010 three‐ to six‐year‐old children in seven Chinese cities (Beijing, Taiyuan, Urumqi, Shanghai, Nanjing, Changsha, and Chongqing) during 2010‐2012 so as to investigate possible links between home renovation and childhood eczema. Their parents responded to questions on home renovation and childhood eczema. Multivariate and two‐level (city‐child) logistic regression analyses yielding odds ratios with 95% confidence intervals were performed. Sensitivity analyses stratifying data for region, climate, and income level were also performed. The prevalences of childhood eczema in children with different floor and wall covering materials were significantly different and were significantly higher with home renovation during early lifetime. Exposure to synthetic materials significantly increased the risk of childhood eczema by 20%‐25%. The risks (AOR, 95% CI) of current eczema among children in families with solid wood flooring and oil paint wall covering were 1.25 (1.04‐1.49) and 1.35 (1.14‐1.60), respectively. Home renovation during pregnancy was related to children's lifetime and current eczema. [ABSTRACT FROM AUTHOR]

Eczema is a common skin condition that impairs children's daily life activities and quality of life. Previous research shows that gut microbiome composition plays an important role in the development of eczema. The present review summarizes evidence on environmental factors related to altered gut microbiota in children with eczema. We searched Medline, PubMed, Embase, and the Cochrane database of Systematic Reviews through October 2015. The search strategy focused on articles published in peer-reviewed, English-language journals with no publication year limit. Only original studies and review articles that reported environmental factors on gut microbiome specific to eczema were included in this review. We selected six studies (total 1990 participants) for full review and identified that the composition of gut microbiota specific to eczema could be influenced by the following environmental factors: length of gestation, mode of delivery, type of feeding, method of treatment, number of older siblings, and other lifestyle factors. There has been inconsistent empirical evidence as to the modulatory effects of gut microbiota on immunological functions in children with eczema. Further research on the environmental-host-microbial interaction is needed to develop a strong base of knowledge for the development and implementation of prevention strategies and policies for eczema. [ABSTRACT FROM AUTHOR]

Background: Specific immunoglobulins G and A (IgG and IgA) for common food items have been extensively measured as surrogate markers of food allergy, and dietary avoidance based on the test results advocated. Aim: We reviewed the prevalence of specific food IgG and IgA in children with eczema and evaluated outcome of dietary avoidance in these children. Methods: Specific immunoglobulins of 96 food items were measured for 30 consecutive atopic dermatitis (AD) patients and disease severity [SCORing atopic dermatitis (SCORAD) and Nottingham eczema severity score (NESS)], Children Dermatology Life Quality Index (CDLQI), skin hydration (SH), transepidermal water loss (TEWL), topical corticosteroid and oral antihistamine usage were evaluated. Twenty seven of these patients received dietary avoidance advice based on IgG and IgA data. General acceptability of treatment (GAT) was documented at the end of 3 months. Results: There were generally no correlations among levels of IgG or IgA of the 96 food items and disease severity, quality of life, SH or TEWL. Two-third patients reported very good or good and one-third reported fair or poor GAT following dietary avoidance advice. There was no difference in any clinical parameters between the two groups following dietary avoidance. Patient with lower sunflower seed IgA ( p = 0.043), casein IgG ( p = 0.041), milk IgG ( p = 0.037) or whey IgG ( p = 0.014) had improved SCORAD and objective SCORAD following dietary advice. Conclusion: Children with AD are sensitized to many food allergens via IgG and IgA mechanisms. Levels of food IgG or IgA do not seem to correlate with any clinical parameters in AD. Subjectively, two third of patients accepted dietary manipulations as very good or good for their AD. Objectively, dietary avoidance had few clinical effects on the clinical parameters. Sensitization should not be generalized to mean allergy to common food. [ABSTRACT FROM AUTHOR]

Background Hand eczema is common in the general population and affects women twice as often as men. It is also the most frequent occupational skin disease. The economic consequences are considerable for society and for the affected individuals. Methods Objectives: To investigate the prevalence and incidence of hand eczema and to evaluate risk factors for development of hand eczema in young adults. Subjects and methods; This is a prospective follow-up study of 2,403 young adults, 16 – 19 years old in 1995 and aged 29 – 32 years, 13 years later, in 2008. They completed a postal questionnaire that included questions regarding one-year prevalence of hand eczema, childhood eczema, asthma, rhinoconjunctivitis and factors considered to affect hand eczema such as hand-washing, washing and cleaning, cooking, taking care of small children and usage of moisturisers. These factors were evaluated with the multinominal logistic regression analysis. Results The one-year prevalence of hand eczema was 15.8% (females 20.3% and males 10.0%, p < 0.001). The incidence was 11.6 cases per 1000 person-years (females 14.3 and males 5.2, p < 0.001). Childhood eczema was the most important risk factor for hand eczema. The odds ratios were 13.17 when having hand eczema 1995 and 2008 compared to 5.17 in 2008 (p < 0.001). A high frequency of hand washing was important in predicting hand eczema only when having 1-year prevalence 2008, OR 1.02 (p = 0.038). Conclusions After 13 years an increased 1-year prevalence of hand eczema was found. The significant risk factors for hand eczema changed over time from endogenous to exogenous factors. [ABSTRACT FROM AUTHOR]

Aims: The aim was to establish a baseline prevalence of skin conditions of public health importance in the general population and taking the validity of the questions into account. Our model is intended for future surveillance of skin conditions. Methods: The suggested questions have for the first time been used in Swedish population surveys. A random sample was taken from the general population aged 16 to 84 years of the participating areas. Results: During the past 12 months, hand eczema was reported by 9.4%, childhood eczema by 15.7% and nickel allergy by 13.7% of the population. Hand and childhood eczema questions have previously been validated. Taking the validity into account, the actual population prevalence of hand eczema (11.7%) is underestimated, and the prevalence of atopic childhood eczema (10.0%) is overestimated based on the results of the questionnaire. In addition to presenting prevalence, population survey results can be used for risk analyses. A 10-fold risk of hand eczema in individuals with childhood eczema and self-reported nickel sensitivity is shown in our study. Conclusions: Questionnaires can be used for epidemiologic surveillance so long as the questions are validated and that the validity is taken into account when estimating the occurrence of the conditions. Public health surveys such as this one lay the basis for future epidemiological surveillance of skin conditions that can be subject to interventions. We propose that these, or similar, questions should be used regularly in population surveys and supplemented by questions on skin exposure. [ABSTRACT FROM AUTHOR]

Background In population-based studies using self-reported nickel allergy, a hand eczema prevalence of 30–43% has been reported in individuals with nickel allergy. In a previous Swedish study, 958 schoolgirls were patch tested for nickel. In a questionnaire follow up 20 years later no association was found between nickel allergy and hand eczema. Objectives To investigate further the relation between nickel allergy and hand eczema. Methods Three hundred and sixty-nine women, still living in the same geographical area, now aged 30–40 years, were patch tested and clinically investigated regarding hand eczema. Results Patch testing showed 30·1% nickel-positive individuals. The adjusted prevalence proportion ratio (PPR) for hand eczema after age 15 years in relation to nickel patch test results was 1·03 (95% confidence interval, CI 0·71–1·50). A history of childhood eczema was reported by 35·9%, and the PPR for hand eczema in relation to childhood eczema was 3·68 (95% CI 2·45–5·54). When analysing the relation separately in women with and without a history of childhood eczema a statistical interaction was found. The hand eczema risk was doubled in nickel-positive women without a history of childhood eczema, with a PPR of 2·23 (95% CI 1·10–4·49) for hand eczema after age 15 years. Conclusions A doubled risk for hand eczema was found in nickel-positive women without a history of childhood eczema. When analysing all participants, there was no statistically significant difference between nickel-positive and nickel-negative women regarding occurrence of hand eczema. The most important risk factor for hand eczema was childhood eczema. The risk for hand eczema in nickel-positive women may previously have been overestimated. [ABSTRACT FROM AUTHOR]

Background: The association between eczema and asthma is well documented, but the temporal sequence of this association has not been closely examined. Objectives: To examine the association between childhood eczema and asthma incidence from preadolescence to middle age, and between childhood eczema and asthma persisting to middle age. A further aim was to examine any effect modification by nonallergic childhood exposures on the association between childhood eczema and both childhood asthma and later life incident asthma. Methods: Data were gathered from the 1968, 1974, and 2004 surveys of the Tasmanian Longitudinal Health Study. Multivariable logistic regression examined the association between childhood eczema and childhood asthma. Cox regression examined the association between childhood eczema and asthma incidence in preadolescence, adolescence, and adult life. Binomial regression examined the association between childhood eczema and childhood asthma persisting to age 44 years. Results: Childhood eczema was significantly associated with childhood asthma and with incident asthma in preadolescence (hazard ratio [HR], 1.70; 95% CI, 1.05-2.75), adolescence (HR, 2.14; 95% CI, 1.33-3.46), and adult life (HR, 1.63; 95% CI, 1.28-2.09). Although childhood eczema was significantly associated with asthma persisting from childhood to middle age (relative risk, 1.54; 95% CI, 1.17-2.04), this association was no longer evident when adjusted for allergic rhinitis. Conclusion: Childhood eczema increased the likelihood of childhood asthma, of new-onset asthma in later life and of asthma persisting into middle age. [Copyright &y& Elsevier]

The skin of patients affected by atopic dermatitis (AD) is extremely susceptible to colonization by Staphylococcus aureus, which plays an important role in AD exacerbations and is correlated with AD extent and severity. The mechanisms by which the bacterium colonizes and infects the skin of patients with AD can be summarized by three different and subsequent steps: 1) a defective skin barrier, on which 2) S. aureus is able to adhere and proliferate thanks to 3) the defective immune response of the skin. Several S. aureus strains can secrete enterotoxins, which can act as superantigens thus contributing to disease severity by inducing a polyclonal T-cell activation and the release of proinflammatory cytokines such as TNFα, IL-1β, IL-2. The production of immunoglobulin E antibodies against staphylococcal exotoxins has also been demonstrated, and the staphylococcal wall protein A has been suggested to act as a "superallergen". Therapeutical actions against S. aureus skin overinfection include both pharmacological (antimicrobial and/or anti-inflammatory therapy and the newer topical calcineurin inhibitors) and nonpharmacological treatments (silk fabric textiles), and are aimed at minimizing skin colonization in order to reduce clinical exacerbations and AD severity. [ABSTRACT FROM AUTHOR]

This is an exploratory research project that enquires into the capabilities of three different groups of paediatric-trained nurses to meet the needs of children and young people with eczema, one of the commonest of chronic conditions of childhood. Data methodology included vignettes and associated questionnaire, which was used with three groups of nurses working with children and young people: students; qualified children's nurses and school nurses. The findings indicated a low level of dermatology nursing knowledge about basic skin care and that some nurses even appeared to avoid those who were disfigured by skin disease. It also raises some questions about whether the disfiguring nature of skin disorders such as eczema can affect a nurse's decision-making ability. [ABSTRACT FROM PUBLISHER]

The aim of this study was to investigate the occurrence of hand eczema after 20 years in women patch tested to nickel during childhood. In 1982–1983, 960 schoolgirls were patch tested for nickel allergy; its prevalence was found to be 9%. 20 years later, the same individuals received a questionnaire regarding hand eczema and factors of importance for the development of hand eczema. 735 of 908 women (80.9%) answered the questionnaire. In total, 17.6% of respondents reported hand eczema after the age of 15 years, and the 1-year prevalence was 12.8%. There was no statistically significant difference in the occurrence of hand eczema between the groups who had previously tested positive and negative for nickel allergy. 38.3% of the respondents considered themselves to be nickel sensitive at the time they answered the questionnaire; in this group, the reported prevalence of hand eczema after age 15 was 22.5%. 31.4% of those with a history of atopic dermatitis reported hand eczema after age 15, compared with 10.6% of those without ( P < 0.001). In conclusion, contact allergy to nickel in childhood did not seem to increase the prevalence of hand eczema later in life. [ABSTRACT FROM AUTHOR]

Background Atopic dermatitis (AD) is common in the population, and studies have shown that the disease is on the increase. Studies based on hospital records reflect selected populations and may miss less severe cases of AD, and the use of self-reported questionnaires has the drawback of recall bias. Objectives To investigate some possible factors influencing recall bias when questionnaires are used to establish the prevalence of childhood eczema in an adult population. Methods A questionnaire regarding past and present eczema was sent to 557 cases (with signs suggesting the diagnosis AD) and 554 matched controls (subjects lacking signs of AD) born during 1960-1969 and identified in school health medical records. Cases and controls were aged 31-42 years at the time of the study and 70.5% returned the questionnaire. Results Of 403 cases, 29% did not report childhood eczema in the questionnaire. There was a difference between those who did recall their childhood AD (remembering group, RG), and those who did not (forgetful group, FG) in who had documented the diagnostic signs in the school health records. In the RG the signs were reported by both parents and school health personnel in 51% of cases, and in the FG this was true of only 16%. The RG had a higher prevalence of eczema after 15 years of age and of hand eczema. The RG also reported more visits to physicians after the age of 15 years and more time taken as sick leave due to eczema. Conclusions Several factors influence how well people remember their AD in childhood. These factors include disease activity in adult life, disease severity, and who noticed the eczema in childhood. [ABSTRACT FROM AUTHOR]

Atopic eczema (AE) is a major risk factor for hand eczema. In Scandinavian population-based studies, the occurrence of AE in childhood has often been assessed by the question ‘Have you had childhood eczema?’ In the present study, this question was validated. A questionnaire was sent to 600 cases with AE and 600 controls without eczema or allergic disease, identified in school medical records from the 1960s. The response rate was 70.5%, and the mean age of the respondents was 36.7 years. The specificity of the question was 70.7% and the sensitivity 89.9%. The sensitivity was higher and the specificity lower in a subgroup with current hand eczema compared with a group without hand eczema. The results showed that the question overestimated the prevalence of AE in childhood by a factor of 1.6. When used for risk assessment, the question provided a better estimate of the risk of current hand eczema as compared with the lifetime risk of hand eczema. In conclusion, the validated question overestimated prevalence of childhood AE and may overestimate AE as a risk factor for hand eczema in adult population surveys. [ABSTRACT FROM AUTHOR]

In a population-based survey of public health issues in Stockholm, Sweden, self-reported hand eczema, history of childhood eczema, nickel allergy, occurrence of skin symptoms on the face and intolerance to cosmetics and hygiene products, were investigated. A postal questionnaire was sent to 15,000 inhabitants aged 19–80 years. The response rate was 73%. The 1-year prevalence of hand eczema was 8% (females 10%, males 6%). History of childhood eczema was reported by 15% and, of these, 42% also stated positively that they had had hand eczema at some time. Hypersensitivity to nickel was owned to 15% of the females and 3% of the males. Of the nickel-sensitive, 30% reported ever having had hand eczema. The combination of nickel allergy and history of childhood eczema resulted in a cumulative prevalence of hand eczema of 56%. Females reported more hand-washings per day than did males, and a relation between number of hand-washings and hand eczema was found. Self-reported 1-year prevalence of skin symptoms on the face was 14% and, of these, 33% also owned to hypersensitivity to cosmetics. Dermatitis appears to be a common health problem. This fact should be made clear to those who give priority and allocate resources to health problems, e.g., by participation of dermatologists in performing population-based surveys. [ABSTRACT FROM AUTHOR]

Factors related to hand eczema were studied. Their relative importance as predictors was ranked by multiple logistic regression analysis. Questionnaires were sent to 20,000 individuals aged 20-65 years, randomly selected from the population register. Those subjects (1385) considering themselves to have had hand eczema within the previous 12 months were invited to a dermatological examination. It was found that a history of childhood eczema was the most important predictive factor for hand eczema. Second was female sex, followed by occupational exposure, a history of asthma and/or hay fever, and a service occupation. A small decrease in risk with advancing age was also found. The difference in the probability of having had eczema in a 1-year period, between individuals having the most important risk factors studied and those having none of them, proved to be for females 48% compared to 8%, and for males 34% compared to 4%. A history of childhood eczema was found to be more common among young persons, indicating an increase in the prevalence of atopic dermatitis. Of those individuals who reported childhood eczema, 27% reported hand eczema on some occasion during the last 12 months. [ABSTRACT FROM AUTHOR]

Eczema is a chronic atopic disease that is highly prevalent among children worldwide. Identification of factors that may contribute to childhood eczema is needed in order to develop strategies in its prevention. Over the past decade, accumulating evidence has suggested a potential correlation between the experience of stress by mothers and the risk of eczema development in their child. The present review attempts to provide an overview of the studies that contribute data on this correlation. The literature search was conducted using five databases, resulting in the inclusion of eleven studies in the review. The findings of these studies were summarized narratively. Further, an appraisal of the reporting quality of the included studies was conducted using a twelve-item checklist adapted from the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Overall, the included studies showed that a positive correlation exists between the experience of stress among mothers and eczema risk of their child. The findings highlight the importance of the implementation of stress reduction programs for pregnant women and those in their postpartum period within communities in order to enable these individuals to relieve stress effectively., Competing Interests: The authors declare no conflicts of interest.