Causes of eczema – the most common skin condition in SG

2021-03-11

Eczema (also known as atopic dermatitis) is the most common skin condition in Singapore, and incidences of eczema in the region are among the highest in the world. According to a report by the National Skin Centre (NSC), one in five children and one in 10 adults in Singapore suffer from eczema, resulting in the most common skin condition treated at the NSC.

Eczema is characterised by itchy and scaly red patches, a dry rash and inflamed skin. There are many factors that may cause or contribute to eczema, including genetics (i.e., family history of an allergy was a significant risk factor for the chronic itchy rash; patient’s parents usually have a history of eczema, allergic rhinitis or asthma.) and environmental allergens (e.g., dust mite, heat, Singapore’s humid weather in particular). Above all, an imbalance in the patient’s gut microbiota is one trigger for eczema.

Gut microbiota regulate our immune system against infection.  An imbalance in gut microbiome (dysbiosis) would render us susceptible to infections. One study revealed that the gut microbiota of atopic dermatitis patients showed a dysbiotic status characterised by a reduction of short-chain fatty acid (SCFA)-producing bacteria (i.e., Bifidobacterium, Blautia, Coprococcus, Eubacterium and Propionibacterium) and an increase in other harmful bacteria. Gut dysbiosis may lead to a dysfunctional immune system that overreacts to irritants or allergens. These overreactions lead to unwanted inflammatory response in the skin which in turn leads to Eczema over time. There are various ways to treat dysbiosis. They include dietary therapy, Fecal Transplants and consumption of probiotics, prebiotics and symbiotics. These treatments in general revolve around the introduction of good bacteria to the gut to restore the imbalance between good and bad bacteria.

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Publications:

Tan TN, Lim DL, Lee BW, Van Bever HP. Prevalence of allergy-related symptoms in Singaporean children in the second year of life. Pediatr Allergy Immunol. 2005 Mar;16(2):151-6. doi: 10.1111/j.1399-3038.2005.00242.x. PMID: 15787873.

Reddel, S., Del Chierico, F., Quagliariello, A. et al. Gut microbiota profile in children affected by atopic dermatitis and evaluation of intestinal persistence of a probiotic mixture. Sci Rep 9, 4996 (2019). https://doi.org/10.1038/s41598-019-41149-6