Effect of climatic change in children with atopic eczema

Background: Climate and sunlight (ultraviolet radiation) influence activity of atopic eczema. Objective: To evaluate the effect of moving from a subarctic/temperate climate to a sunny subtropical climate on children's atopic eczema. Methods: Children, 4-13 years, with severe atopic eczema were randomized to stay 4 weeks in Gran Canary (index patients = 30) and home in Norway (controls = 26), with a follow up of 3 months. SCORing of Atopic Dermatitis (SCORAD) was primary variable, and secondary were Children's Dermatology Life Quality Index (CDLQI), Staphylococcus aureus skin colonization and pharmacological skin treatment. Results: SCORing of Atopic Dermatitis decreased from 37.2 (29.4-44.9) to 12.2 (9.0-15.4) [mean (95% confidence intervals)] after 4 weeks and 21.2 (17.2-25.1) 3 months thereafter in index patients (P < 0.0005), much less in controls.Children's Dermatology Life Quality Index in the index group improved from 8.7 to 2.2 and 4.5 after 4 weeks and 3 months (P < 0.0005), not in controls. Bacterial skin colonization with S. aureus decreased in the index group from 23/30 (77%) to 12/30 (40%; P = 0.001) and 12/30 (40%; P = 0.005) after 1 month and 3 months, and the use of local steroids decreased in index patients but not in controls. Conclusions: The change from a subartic/temperate to a subtropical climate for 4 weeks improved significantly skin symptoms (SCORAD) and quality of life, even for 3 months after return.