MedWire News: Nylon clothing, dust, unfamiliar pets, sweating, and shampoos may be triggers for eczema flares in children, a UK study has found.
There is little objective analytic scientific data to support roles of potential environmental triggers in provoking flares of eczema in children, note Sinead Langan (University of Nottingham) and colleagues.
To assess the role of various environmental factors on severity of eczema in children, they studied 60 children aged 0-15 years with eczema for 6-9 months. Overlapping start dates allowed study of seasonal factors over a full year.
Daily electronic diaries and portable data loggers recorded indoor exposures, and external meteorological data were obtained from a local monitoring center. The primary outcome measure was a daily “bother” score, recording: “How much bother did your (your child’s) eczema cause today?”
Autoregressive moving average models modeled the impact of exposures on eczema severity for individuals. Random effects modeling pooled estimated regression coefficients across participants.
Increased eczema severity was associated with nylon clothing (pooled regression coefficient 0.23), dust (0.53), unfamiliar pets (0.22), sweating (0.24), and shampoo (0.07). The latter was enhanced in cold weather (0.30).
Nylon clothing specifically increased eczema severity on the trunk and limbs, wool clothing on the trunk, and unfamilial pets on hands.
A combination of any three of seven likely variables was associated with disease worsening. A linear relationship was observed between each additional exposure and eczema worsening.
Writing in the British Journal of Dermatology, the researchers comment: “Our study indicates associations between eczema worsening and irritant exposure. Specifically, associations were seen between washing a child’s hair at the same time as the bath or shower and worsening of eczema.”
They note: “Interactions were seen between this response and low environmental temperature… This observation may relate to the role of filaggrin mutations in eczema leading to impaired skin barrier function and warrants further study.”
The researchers recommend: “Future research with increased participant numbers is required to assess the association between multiple concurrent exposures and disease and shampoo formulations in relation to worsening of eczema.”
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009
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