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National Primary
Care Research and Development Centre/Institute for Public Health
Research and Policy, University of Salford
Correspondence to: Professor Popay, Institute for Public Health Research and Policy University of Salford, 4th Floor, Humphrey Booth House, The Crescent, Salford M5 4QA (j.m.popay{at}salford.ac.uk)
Accepted for publication 17 February 2000
Atopic eczema is a chronic skin condition affecting between 5%
and 20% of children aged up to 11 years at one time or other. Research
suggests that prevalence is increasing and various environmental factors have been implicated in the aetiology. While often seen to be a
minor problem, research suggests that it can cause considerable disruption to the lives of children and their carers and involves significant cost for the family and health care systems. The current consensus is that the majority of cases of atopic eczema are most appropriately managed within primary care. However, management of the
condition is problematic because diagnosis is often difficult. Consultations tend to focus on the physical aspects of the problems neglecting the psychosocial, while treatment remains mainly palliative and can be as diverse as the condition itself. More appropriate and
effective primary care management and support for children with atopic
eczema and their carers will only be developed if health professionals
become more aware of the social context of the disease and the impact
on the lives of those affected. Public health responses focusing on
primary prevention are also needed. This paper reviews a diverse
literature on the epidemiology of the condition, the way in which it
affects the lives of children and their carers and the factors that
shape their help seeking decisions. The aim is to contribute to a more
substantial knowledge base for public health and primary care
developments and to point to areas for future research
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