What's new in atopic eczema? An analysis of systematic reviews published in 2012 and 2013. Part 1. Epidemiology, mechanisms of disease and methodological issues.

This review provides a summary of key findings from nine systematic reviews on atopic eczema (AE) published over the 2-year period from January 2012 to 31 December 2013, focusing on epidemiology, mechanisms of disease and methodological issues. There is now reasonable evidence to suggest that antibiotic exposure in early life is associated with increased incidence of AE, but delivery by caesarean section is not. The prevalence of AE is increasing in Africa, eastern Asia, western Europe and parts of northern Europe. Autoimmunity may play a part in the development and subsequent severity of AE. For researchers conducting clinical trials and other prospective studies involving patients with AE, the two best-validated scales for capturing objective clinical signs of AE are the Eczema Assessment Severity scale (EASI) and the objective SCORing Atopic Dermatitis scale (objSCORAD). For the assessment of quality of life in children aged 0-3 years, the Infant Dermatitis Quality of Life scale (IDQoL) is reasonably well validated. A standardized definition of an incident case of AE for use in prevention studies is still required.