Eczema (atopic dermatitis) is a skin condition which causes dry and sore skin. It affects up to 20% of children worldwide. In some children their eczema symptoms will improve and resolve as they get older, but in others the symptoms can persist throughout childhood and severely impact quality of life. If we could identify the children who are likely to go on to have persistent or severe eczema, they could be offered more intensive or different treatment for their eczema. There have been several studies to define subtypes of eczema, such as early-onset resolving or persistent, and to try to identify which early life factors are associated with each subtype. However, the evidence so far is conflicting, there are no clinical risk prediction tools available, and most studies have only involved children of European ancestry. There is a critical need for a clinical risk prediction algorithm that could facilitate teat decision-making in clinic and inform whether emergent treatments are disease-modifying.

This study will analyse existing data from birth cohort studies which include children from a range of ethnic groups. Within each cohort we will group children with eczema into subgroups, according to the age at first symptoms, whether the symptoms come and go over time or are persistent, and the severity of the symptoms. Then we will investigate whether persistent or severe eczema (compared to resolving eczema) is linked to early factors such as family history of eczema, sex at birth, birth weight, ethnicity, breastfeeding and genetic factors.
We will develop prognostic models to help counsel parents on treatment decisions and stratify patients in future clinical trials. Within each cohort, we will also examine a longer list of early life factors that may be more challenging to measure to examine how much they increase the utility of the prognostic models. Comparison of the findings between cohorts will identify common predictors of persistent eczema which could help target treatment to children at risk, and identify areas that may require additional focus.