title: Severe eczema in infancy can predict asthma development. A prospective study to the age of 10 years.
abstract: BACKGROUND
  Children with atopic eczema in infancy often develop allergic rhinoconjunctivitis and asthma, but the term "atopic march" has been questioned as the relations between atopic disorders seem more complicated than one condition progressing into another.
  
  
  OBJECTIVE
  In this prospective multicenter study we followed children with eczema from infancy to the age of 10 years focusing on sensitization to allergens, severity of eczema and development of allergic airway symptoms at 4.5 and 10 years of age.
  
  
  METHODS
  On inclusion, 123 children were examined. Hanifin-Rajka criteria and SCORAD index were used to describe the eczema. Episodes of wheezing were registered, skin prick tests and IgE tests were conducted and questionnaires were filled out. Procedures were repeated at 4.5 and 10 years of age with additional examinations for ARC and asthma.
  
  
  RESULTS
  94 out of 123 completed the entire study. High SCORAD points on inclusion were correlated with the risk of developing ARC, (B = 9.86, P = 0.01) and asthma, (B = 10.17, P = 0.01). For infants with eczema and wheezing at the first visit, the OR for developing asthma was 4.05(P = 0.01). ARC at 4.5 years of age resulted in an OR of 11.28(P = 0.00) for asthma development at 10 years.
  
  
  CONCLUSIONS
  This study indicates that infant eczema with high SCORAD points is associated with an increased risk of asthma at 10 years of age. Children with eczema and wheezing episodes during infancy are more likely to develop asthma than are infants with eczema alone. Eczema in infancy combined with early onset of ARC seems to indicate a more severe allergic disease, which often leads to asthma development. The progression from eczema in infancy to ARC at an early age and asthma later in childhood shown in this study supports the relevance of the term "atopic march", at least in more severe allergic disease.
authors.affiliation: Division of Pediatrics, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University and Department of Pediatrics, County Council of Östergötland, Linköping, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Ekbäck
authors.affiliation: Pediatric Clinic, Täby, Stockholm, Sweden.
authors.forename: Michaela
authors.initials: M
authors.lastname: Tedner
authors.affiliation: Division of Pediatrics, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University and Department of Pediatrics, County Council of Östergötland, Linköping, Sweden.
authors.forename: Irene
authors.initials: I
authors.lastname: Devenney
authors.affiliation: Pediatric Clinic, County Hospital Ryhov, Jönköping, Sweden.
authors.forename: Göran
authors.initials: G
authors.lastname: Oldaeus
authors.affiliation: Pediatric Clinic, Hudiksvall, Sweden.
authors.forename: Gunilla
authors.initials: G
authors.lastname: Norrman
authors.affiliation: Department of Pediatrics in Norrköping, County Council of Östergötland, Norrköping, Sweden.
authors.forename: Leif
authors.initials: L
authors.lastname: Strömberg
authors.affiliation: Division of Pediatrics, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University and Department of Pediatrics, County Council of Östergötland, Linköping, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Fälth-Magnusson
mesh_terms: D001249:Asthma / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D004485:Eczema / Q000150:complications*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors