CHILDHOOD ECZEMA - DISEASE OF THE ADVANTAGED

Objective-To determine whether the increased prevalence of childhood eczema in advantaged socioeconomic groups is due to increased parental reporting. Design-Comparison of parental reports of eczema with visible eczema recorded by medical officers during a detailed physical examination. Setting-National birth cohort study. Subjects-8279 children from England, Wales, and Scotland born during 3-9 March 1958 and followed up at the ages of 7, 11, and 16. Main outcome measures-Prevalence of eczema according to parental report compared with medical officer's examination at the ages of 7, 11, and 16. Results-Prevalence of both reported and examined eczema increased with rising social class at the ages of 7, 11, and 16 years. The point prevalence of examined eczema at age 7 was 4.8%, 3.6%, 3.6%, 2.4%, 2.2%, and 2.4% in social classes I, II, III nonmanual, III manual, TV, and V respectively (chi(2) value for linear trend 12.6, P < 0.001). This trend persisted after adjustment for potential confounders such as region and family size and was not present for examined psoriasis or acne. Conclusions-Eczema is more prevalent among British schoolchildren in social classes I and II than those in lower classes, Exposures associated with social class are probably at least as important as genetic factors in the expression of childhood eczema.