Epidemiologie des atopischen ekzems

The atopic eczema constitutes the most frequent inflammatory skin disease in childhood. The disease is best assessed by a clinical diagnosis of a physician who is experienced in skin diseases. For epidemiologic purposes in the UK, easy to use and valid diagnostic criteria have been developed. Several studies proved a significant increase in western industrialized countries over the past decades. Comparable studies are not available for Germany so far. Taking German studies into consideration which rely on an actual dermatological examination the prevalence of atopic eczema can be estimated with 3% for adults and 12% for preschool children, with girls being more frequently affected. The atopic eczema is characterized by an early onset (57 - 73% before first year of live), a cyclic course, and a spontaneous remission in some patients during adulthood (17 - 56%). 48 65% of the patients notice an improvement during summer months and 10 - 30% report a worsening by certain food. Psychological moods can influence the skin condition in about 35.5% of the affected patients. Besides the genetic predisposition several external risk factors have been identified by epidemiologic studies. These include the socioeconomic status and exposure to aeroallergens, especially house dust mite and pets (rodents). Air pollutants can also influence the manifestation of the eczema. According to the corresponding studies this is true for tobacco smoke (also during pregnancy), indoor NO(x), and traffic-related emissions. In addition comparative studies in East and West Germany showed a significantly increased prevalence of eczema in East Germany. Although these results contribute tO the better understanding of the multifactorial genesis of the atopic eczema, the reasons for its increase are not clarified yet.