• atopic eczema;
  • atopy;
  • natural history;
  • prevalence;
  • risk factors

Eczema is a common infantile disease but its nature and extent during later childhood remains unclear. In a whole-population birth cohort study (n = 1456) we examined prevalence and characteristics of eczema amongst 10-year-old children. At this age 1373 (94%) children completed ISAAC questionnaires, 1043 (72%) skin prick testing and 953 (65%) serum inhalant IgE antibody screening. At 10 years of age prevalence of eczema ever was 41.0% and for current eczema was 13.7% (combined current itchy rash and eczema ever). Most current eczema (71.0%) began before 4 years of age, but was associated with low morbidity at 10 years. Amongst children with diagnosed eczema at 4 years of age, 56.3% had current eczema at 10 years. Atopy (positive skin test) and other allergic states were associated with current eczema (p < 0.001). Risk factor analysis for current eczema identified independent significance for atopy (p = 0.01), rhinitis (p = 0.04) and food allergy (p = 0.01) at 4 years, plus maternal asthma (p = 0.03). Diagnosed rhinitis at 4 years emerged as a significant predictor of persistent disease. Eczema is not simply a transient infantile condition but a common problem at 10 years of age, often reflecting persistent disease from early childhood. Inherited predisposition towards atopy is the predominant risk factor for this state.