Prognosis of unclassified eczema - A follow-up study

Objective: To investigate the outcome of unclassified eczema (UE). Eczema refers to a set of highly heterogeneous clinical conditions including contact dermatitis (CD) and several types of endogenous eczema. In clinics, however, the eczema of a large proportion of patients does not fit any known patterns and has been diagnosed as unclassified eczema. The prognosis of UE is largely unknown. Design: Cohort study with I-year follow-up. Setting: Dermatology clinic in Peking University Third Hospital, Beijing, China. Patients: All cases of UE in 655 consecutive patients with eczema patch tested with the European Standard series occurring during a 2-year period. Interventions: At I year after patch testing, all patients were asked to revisit the clinic, and 599 patients returned (91.5%); of these, 192 had UE (32.1%). Main Outcome Measures: The rate of symptom-free skin for at least 3 months without relapse before evaluation. Results: During the follow-up period, only 15.1% of patients, with UE had their lesions cleared, which was a much lower rate than for those with CD (50.4%) (P <.00 1; chi(2) test) but close to the rate of those with atopic dermatitis (7.1%). A to tal of 11.0% of patients with UE had atopic diathesis, and 72.4% of those with UE had a positive reaction to at least 1 contact allergen, which was a lower rate than that of patients with allergic CD (88.6%) but higher than that for patients with irritant CD (53.8%) (P <.001 and P=.004, respectively; chi(2) test); however, none of these results were relevant to eczema. Conclusions: Unclassified eczema is a common type of eczema with a very poor prognosis. This important category of eczema should be recognized and studied further.