Early Onset Eczema and the Association with Early Onset Asthma
Sunday, March 4, 2018
South Hall A2 (Convention Center)
Heather R. Cassell, MD, Debra A Stern, Anne L. Wright, PhD, Fernando D. Martinez, MD

RATIONALE: Eczema has long been identified as a potential risk factor for developing asthma. Little is known about how asthmatics with early onset eczema differ from their peers without early onset eczema. We explored the hypothesis that age of onset of asthma in children with early onset eczema (<2 years at diagnosis), who develop subsequent asthma, would do so at an earlier age compared with those with asthma and no eczema.

METHODS: The Tucson Children’s Respiratory Study, a non-selected birth cohort, surveyed participants at multiple ages through 32 years. Early eczema was physician diagnosed before 2 years. Asthma was physician diagnosed with symptoms during the past year. Age at asthma incidence from 6 to 32 years was the outcome for a survival analysis comparing early eczema to no eczema.

RESULTS: Eczema and asthma information was available for 988 participants. Early eczema prevalence was 9.1%; 4.6% started by 6 months and 4.5% started between 6 and 24 months.

Overall, children with eczema were twice as likely to develop asthma by age 32, HR=2.0 (1.5, 2.7) p<0.001. Eczema was associated with early onset asthma: 80.9% of those with eczema were diagnosed with asthma before 11 years compared to 47.9% of those without eczema, p<0.001. There was no differential risk for asthma if eczema started before or after 6 months, p=0.4. Early eczema was not a risk factor for asthma starting after age 18.

CONCLUSIONS: Early onset eczema is a risk factor for asthma that starts in childhood.