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A Follow-up Study

Lin-feng Li, MD, PhD; Guangren Liu, MD; Jing Wang, MD

Arch Dermatol. 2008;144(2):160-164.

Objective  To investigate the outcome of unclassified eczema (UE). Eczema refers to a set of highly heterogeneous clinical conditions including contact dermatitis (CD) and several types of endogenous eczema. In clinics, however, the eczema of a large proportion of patients does not fit any known patterns and has been diagnosed as unclassified eczema. The prognosis of UE is largely unknown.

Design  Cohort study with 1-year follow-up.

Setting  Dermatology clinic in Peking University Third Hospital, Beijing, China.

Patients  All cases of UE in 655 consecutive patients with eczema patch tested with the European Standard series occurring during a 2-year period.

Interventions  At 1 year after patch testing, all patients were asked to revisit the clinic, and 599 patients returned (91.5%); of these, 192 had UE (32.1%).

Main Outcome Measures  The rate of symptom-free skin for at least 3 months without relapse before evaluation.

Results  During the follow-up period, only 15.1% of patients with UE had their lesions cleared, which was a much lower rate than for those with CD (50.4%) (P < .001; ² test) but close to the rate of those with atopic dermatitis (7.1%). A total of 11.0% of patients with UE had atopic diathesis, and 72.4% of those with UE had a positive reaction to at least 1 contact allergen, which was a lower rate than that of patients with allergic CD (88.6%) but higher than that for patients with irritant CD (53.8%) (P < .001 and P = .004, respectively; ² test); however, none of these results were relevant to eczema.

Conclusions  Unclassified eczema is a common type of eczema with a very poor prognosis. This important category of eczema should be recognized and studied further.

Author Affiliations: Department of Dermatology, Peking University Third Hospital, Beijing, China.

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