The editorial includes part of a series of annual updates summarizing the evidence base for atopic eczema (AE). It offers a summary of significant findings from 28 systematic analyses, which were published or indexed during 2017, and it emphasizes on the epidemiology, etiology and risk factors of AE.

AE is one of the major single contributor to morbidity that is associated with skin disease globally, once mortality is excluded. Also, there is a high incidence of sleep disorders in individuals with AE and more sick leaves are taken by these patients than in controlled ones. Although there is a lack of skin bacterial diversity in AE patients, there is a comparative abundance of Staphylococcus aureus and Staphylococcus epidermidis. Affected individuals often show an IgE response to S. aureus antigens and have greater serum interleukin-31 levels as compared with controls.

Early antibiotic exposure, maternal atopy, environmental pollutants and food allergy are also associated with an increased risk of AE, whereas preterm birth is associated with lower risk. Patients with AE also have a lower risk of meningioma, but might possibly develop attention-deficit hyperactivity disorder as compared with controls. Patients with eosinophilic oesophagitis are more likely than unaffected individuals to have AE. No significant overall association between AE and allergic contact dermatitis (ACD) was observed. In children, who were referred for patch testing, ACD was more common in those without AE. Furthermore, hand eczema is more widespread in patients with AE. Moreover, there was no association between AE and hypertension, type 2 diabetes, stroke or myocardial infarction.

Source: Hale G, Davies E, Grindlay DJC, Rogers NK, Harman KE. Whats new in atopic eczema? An analysis of systematic reviews published in 2017. Part 2: epidemiology, aetiology and risk factors. Clin Exp Dermatol. 2019;44(8):868‐873. doi:10.1111/ced.14075