title: Predicting eczema severity beyond childhood.
abstract: BACKGROUND
  We evaluated factors associated with eczema severity in adolescence.
  
  
  METHODS
  Nottingham Eczema Severity Score (NESS), family and personal history of atopy, skin prick test for common food and aeroallergens, highest serum IgE level and eosinophil count were evaluated. Patients with paired NESSs (childhood-NESS is NESS performed at <10 years of age; adolescence-NESS is NESS performed at age >10 years) were further analyzed.
  
  
  RESULTS
  Adolescence-NESS (n=383 patients) was associated with eczema onset in infancy, dust mite and food allergen sensitization, dietary avoidance, use of wet wrap, traditional Chinese medicine, immunomodulant (azathioprine or cyclosporine), high IgE level, eosinophil count, but not with family/personal history of atopy. Eighty-two patients had both childhood-NESS and adolescence-NESS (mean follow-up of 6.8 years) showing that adolescence-NESS was associated with childhood- NESS severity grades (P=0.034). Of these patients, 48% remained in the same severity grades, whereas 39% improved, and 13% deteriorated from childhood to adolescence.
  
  
  CONCLUSIONS
  It is not possible to assure parents that their child can outgrow eczema. In eczema prognosis research, long-term follow-up is warranted.
authors.affiliation: Department of Pediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. ehon@hotmail.com.
authors.forename: Kam Lun
authors.initials: KL
authors.lastname: Hon
authors.affiliation: Department of Pediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
authors.forename: Yin-Ching K
authors.initials: YC
authors.lastname: Tsang
authors.affiliation: Department of Pediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
authors.forename: Terence Chuen W
authors.initials: TC
authors.lastname: Poon
authors.affiliation: Department of Pediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
authors.forename: Nga Hin
authors.initials: NH
authors.lastname: Pong
authors.affiliation: Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: Matthew
authors.initials: M
authors.lastname: Kwan
authors.affiliation: Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: Shirley
authors.initials: S
authors.lastname: Lau
authors.affiliation: Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: Yuen-Chun
authors.initials: YC
authors.lastname: Chiu
authors.affiliation: Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: Hin-Hei
authors.initials: HH
authors.lastname: Wong
authors.affiliation: Department of Pediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
authors.forename: Ting-Fan
authors.initials: TF
authors.lastname: Leung
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D004485:Eczema / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: Nottingham Eczema Severity Score; atopic dermatitis; atopy; eczema; prognosis