Prognosis

Good Prognostic indicators:

• early onset and typical involvement - flexural surfaces
• 90% resolution by early teens
• may be recurrence of the disorder in adulthood if there are circumstances where there is undue stress of the skin eg the hands of a hairdresser

Poor Prognostic indicators:

• a more guarded prognosis should be given to those where the condition has a later onset and/or a atypical pattern of involvement (ie extensor surfaces).

Evidence from the British 1958 birth cohort study (1) reveals:

• in the context of children with reported or examined eczema by the age of 7 years
  • the proportion of children who were clear in terms of examined eczema or reported eczema in the last year at ages 11 and 16 years was 65% and 74%, respectively (these 'apparent' or short-term clearance rates fell to 53% and 65%, respectively, after allowance for subsequent recurrences in adolescence and early adulthood)

However the Odense Adolescence Cohort Study (TOACS) showed that up to 50% of patients had persistent eczema in adulthood (2)

Reference:

• (1) Br J Dermatol 1998 Nov;139(5):834-9 The natural history of childhood eczema: observations from the British 1958 birth cohort study. Williams HC, Strachan DP.
• (2) Mortz CG et al. Atopic dermatitis from adolescence to adulthood in the TOACS cohort: prevalence, persistence and comorbidities. Allergy 2015;70(7):836–45