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Trends in eczema prevalence in children and adolescents: A Global Asthma Network Phase I Study

Langan, Sinéad Máire; Mulick, Amy R.; Rutter, Charlotte E.; Silverwood, Richard J.; Asher, Innes; García‐Marcos, Luis; Ellwood, Eamon; Bissell, Karen; Chiang, Chen‐Yuan; Sony, Asma El; Ellwood, Philippa; Marks, Guy B.; Mortimer, Kevin; Martínez‐Torres, A. Elena; Morales, Eva; Perez‐Fernandez, Virginia; Robertson, Steven; Williams, Hywel C.; Strachan, David P.; Pearce, Neil

Trends in eczema prevalence in children and adolescents: A Global Asthma Network Phase I Study Thumbnail


Sinéad Máire Langan

Amy R. Mulick

Charlotte E. Rutter

Richard J. Silverwood

Innes Asher

Luis García‐Marcos

Eamon Ellwood

Karen Bissell

Chen‐Yuan Chiang

Asma El Sony

Philippa Ellwood

Guy B. Marks

Kevin Mortimer

A. Elena Martínez‐Torres

Eva Morales

Virginia Perez‐Fernandez

Steven Robertson

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Professor of Dermato-Epidemiology

David P. Strachan

Neil Pearce


Background: Eczema (atopic dermatitis) is a major global public health issue with high prevalence and morbidity. Our goal was to evaluate eczema prevalence over time, using standardized methodology. Methods: The Global Asthma Network (GAN) Phase I study is an international collaborative study arising from the International Study of Asthma and Allergies in Children (ISAAC). Using surveys, we assessed eczema prevalence, severity, and lifetime prevalence, in global centres participating in GAN Phase I (2015–2020) and one/ both of ISAAC Phase I (1993–1995) and Phase III (2001–2003). We fitted linear mixed models to estimate 10-yearly prevalence trends, by age group, income, and region. Results: We analysed GAN Phase I data from 27 centres in 14 countries involving 74,361 adolescents aged 13–14 and 47,907 children aged 6–7 (response rate 90%, 79%). A median of 6% of children and adolescents had symptoms of current eczema, with 1.1% and 0.6% in adolescents and children, respectively, reporting symptoms of severe eczema. Over 27 years, after adjusting for world region and income, we estimated small overall 10-year increases in current eczema prevalence (adolescents: 0.98%, 95% CI 0.04%–1.92%; children: 1.21%, 95% CI 0.18%–2.24%), and severe eczema (adolescents: 0.26%, 95% CI 0.06%–0.46%; children: 0.23%, 95% CI 0.02%–0.45%) with larger increases in lifetime prevalence (adolescents: 2.71%, 95% CI 1.10%–4.32%; children: 3.91%, 95% CI 2.07%–5.75%). There was substantial heterogeneity in 10-year change between centres (standard deviations 2.40%, 0.58%, and 3.04%), and strong evidence that some of this heterogeneity was explained by region and income level, with increases in some outcomes in high-income children and middle-income adolescents. Conclusions: There is substantial variation in changes in eczema prevalence over time by income and region. Understanding reasons for increases in some regions and decreases in others will help inform prevention strategies.


Langan, S. M., Mulick, A. R., Rutter, C. E., Silverwood, R., Asher, I., García‐Marcos, L., …Pearce, N. (2023). Trends in eczema prevalence in children and adolescents: A Global Asthma Network Phase I Study. Clinical & Experimental Allergy, 53(3), 337-352.

Journal Article Type Article
Acceptance Date Nov 30, 2022
Online Publication Date Feb 8, 2023
Publication Date 2023-03
Deposit Date Feb 14, 2023
Publicly Available Date Feb 14, 2023
Journal Clinical & Experimental Allergy
Print ISSN 0954-7894
Electronic ISSN 1365-2222
Peer Reviewed Peer Reviewed
Volume 53
Issue 3
Pages 337-352
Keywords atopic dermatitis, eczema, flexural rash, global estimates, prevalence
Public URL
Publisher URL
Additional Information Received: 2022-08-31; Accepted: 2022-11-30; Published: 2023-02-08