Prevalence of eczema symptoms in the second year of life*1

Rationale Data on symptom prevalence of common childhood allergies in early life is scant although their onset can occur in early childhood. Data for Singapore's pediatric population is obtained for the first time. Methods 1026 children took part in this cross-sectional allergy survey. Median age is 21 months (range:18.5 to 23 months old). Eczema was described as an ‘itchy rash that persisted or recurred' with an optional flexural distribution. ‘Current' symptoms imply occurrence in past 12 months. Results Cumulative prevalence of eczema (i.e. a persistent/recurrent rash) and wheeze in the second year of life are 22.7% (227/1000) and 23.2% (235/1014) respectively, this is in contrast to the low 8.4% (86/1005) reported for current rhinoconjunctivitis. The majority of subjects (86.4%, n=192/222) who reported eczema also reported current flexural distribution characteristic of atopic dermatitis; yet only 35.6% (78/219) reported doctor-diagnosed eczema. Neither sex is at higher risk of reporting eczema (p>0.05). Factors which increase the risk of eczema include ethnic Chinese (OR1.4, 95% CI:1.0-2.0); tertiary-educated mothers (OR1.7, 95%CL:1.3-2.3); dog-keeping during mother's pregnancy with child (OR2.0, 95% CI:1.2-3.4), family history of allergy (OR1.9, 95%CI:1.4-2.5); and comorbid allergy symptoms such as wheeze (OR1.5, 95% CI:1.1-2.1) and rhinoconjunctivitis (OR2.1, 95% CI:1.3-3.4). Conclusions More than one in five children develop eczema (i.e. persistent/recurrent rash) by the second year of life. While the majority exhibited the classic flexural pattern seen in atopic dermatitis, nearly two-thirds were undiagnosed. Chronic rash in early life also shows association with comorbid allergy symptoms and with dog-keeping during pregnancy.