Hand eczema and atopic dermatitis in adolescents: a prospective cohort study from the BAMSE project

Background There is a well-known association between atopic dermatitis (AD) and hand eczema but less is known about how age at onset, persistence and severity of AD influence the risk of developing hand eczema. Objectives To examine the role of AD in the occurrence of hand eczema in adolescence. In addition, associations between asthma and rhinoconjunctivitis, sensitization to common airborne and food allergens, and hand eczema were studied. Methods From the population-based birth cohort BAMSE, 2927 adolescents who had been followed up repeatedly concerning allergy-related disease were included. Questionnaires identified adolescents with hand eczema at 16 years, and their blood was analysed for specific IgE. Results A total of 152 (5.2%) adolescents had hand eczema at the age of 16 years. Many of these adolescents had a history of AD (n = 111; 73.0%) and asthma and/or rhinitis (n = 83; 54.6%), respectively. Children with AD (aged 0-16 years) had more than threefold increased odds ratios (OR) for having hand eczema; those with persistent or severe AD had a crude OR of 6.1 [95% confidence interval (CI) 4.0-9.1] and 5.3 (95% CI 2.9-9.6), respectively. Conclusions We confirm a strong association between AD during childhood and hand eczema in adolescence. Children with persistent or more severe AD are at greater risk of developing hand eczema. Asthma and/or rhinoconjunctivitis, positive specific IgE or age at onset of AD are not associated with hand eczema in adolescence.