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Antibiotics may increase eczema risk in children, study reveals

Use of antibiotics in early life may increase the risk of developing eczema by up to 40 per cent, according to a new study in the British Journal of Dermatology.

The research also found that each additional course of antibiotics further raised the risk of eczema by seven per cent.

The researchers, from Guy’s and St Thomas’ NHS Foundation Trust, King’s College London, the University of Nottingham and the Aberdeen Royal Infirmary, reviewed existing data from 20 separate studies that explored the link between antibiotic exposure prenatally and in the first year of life, and the subsequent development of eczema. They also examined whether the number of antibiotic courses affected the chances of developing the disease.

They found that children with eczema are more likely to have been treated with antibiotics in the first year of life, but not prenatally.

“One potential explanation is that broad-spectrum antibiotics alter the gut microflora and that this in turn affects the maturing immune system in a way that promotes allergic disease development”, said one of the study authors Dr Teresa Tsakok of Guy’s and St Thomas’.

The paper’s senior author Dr Carsten Flohr, King’s College London and Guy’s and St Thomas’, added: “A better understanding of the complex relationship between antibiotic use and allergic disease is a priority for clinicians and health policymakers alike, as determination of a true link between antibiotic use and eczema would have far-reaching clinical and public health implications.”

Nina Goad of the British Association of Dermatologists said: “Eczema is our most common skin disease, affecting one in every five children in the UK at some stage and causing a significant burden to the patient and the health service. Allergic diseases including eczema have increased over past decades, particularly for children in high income countries, but the causes for this are not fully understood. The evidence is not conclusive and the researchers are not suggesting that parents should withhold antibiotics from children when doctors feel such treatment is necessary, but studies like this give an insight into possible avoidable causes and may help to guide medical practice.”

The researchers added a note of caution to their findings, explaining that use of antibiotics may in fact be a consequence of an increased occurrence of infections in children with eczema. Further research is needed that carefully examines the sequence of events between the age antibiotics are prescribed and the onset of eczema development.

Notes to editors:

1. For more information, please contact: Nina Goad or Deborah Mason, British Association of Dermatologists, Phone: 0207 391 6094 / 6355, Email: comms@bad.org.uk, Website: www.bad.org.uk
2. To speak to Dr Carsten Flohr, please call the British Association of Dermatologists on 0207 391 6355 / 6094 or Guy’s and St Thomas’ press office on 020 7188 5577. To speak to Dr Teresa Tsakok, please call the British Association of Dermatologists.
Embargo to 00.01hrs, Thursday June 20th 2013.
3. If using this information, please ensure you mention that the study is being released in the British Journal of Dermatology, the official publication of the British Association of Dermatologists. Study details: Does early life exposure to antibiotics increase the risk of eczema? A systematic review
T. Tsakok1; T.M. McKeever2, L. Yeo3, C. Flohr4
1 Academic Clinical Fellow, Guy’s and St Thomas’ Hospital NHS Foundation Trust, London, UK
2 Division of Epidemiology and Public Health, University of Nottingham, City Hospital, Nottingham, UK
3 Department of Dermatology, Aberdeen Royal Infirmary, Aberdeen, UK
4 Department of Paediatric Dermatology, St John’s Institute of Dermatology, Guy’s & St Thomas’ Hospital NHS Foundation Trust and King’s College London, London, UK
Print publication date TBC; Draft, unedited version due to appear in Accepted Articles section online on 24.06.2013. DOI: available on request on publication. Articles in the BJD can be viewed online: www.brjdermatol.org

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease. For further information about the charity, visit www.bad.org.uk . Wiley-Blackwell, created in February 2007 by merging Blackwell Publishing with Wiley's Global Scientific, Technical, and Medical business, is now one of the world's foremost academic and professional publishers and the largest society publisher. With a combined list of more than 1,400 scholarly peer-reviewed journals and an extensive collection of books with global appeal, this new business sets the standard for publishing in the life and physical sciences, medicine and allied health, engineering, humanities and social sciences. For more information visit www.wiley.com

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Sunbeds blamed for high skin cancer rates in young women in North West, study reveals

Rates of the deadliest form of skin cancer are unusually high in young women in the North West of England, with sunbeds and cheap holidays to blame, according to research published today in the British Journal of Dermatology.

Historically, incidence of melanoma has always been higher in the more southerly latitudes of England, where the hours of sunshine are longer than in northern regions, especially during the summer season.

However, this latest study has found an alarming reversal in this trend in young women aged 10-29, with the disease for this age group most prevalent in the North West.

A further interesting finding of the study, carried out by researchers at the University of Manchester, relates to the socioeconomic status of melanoma patients. Previous data has long established that the disease is most prevalent in more affluent people, which is largely thought to be due to opportunities for foreign travel to sunnier climates, and other lifestyle factors.

However, among young women in the North, the disease was found to be high among the second most deprived socioeconomic group, as well as the second most affluent groups.

Nina Goad of the British Association of Dermatologists said: “This study is interesting as it changes our views on two important risk factors for skin cancer – where we live and how rich we are. Latitudinal position in England has long been associated with risk levels for skin cancer, with southern regions always having the highest rates of the disease. But for young women, the disease is now highest in the North West.

“Previously the disease has consistently been found to be more common amongst the most affluent in society, but in this same group of young women in Northern England, the disease is now also high amongst the most deprived. We know that across England, use of tanning beds is highest among young women in the north and is also high among lower socioeconomic status groups, so this may well be a strong contributing factor to both these findings.”

Sarah Wallingford, from the University of Manchester’s Institute for Inflammation and Repair who led the research working with colleagues at the University of Manchester and the Queensland Institute of Medical Research, Brisbane, Australia, concludes: “The affordability of sun holidays and high prevalence of sunbed use among young adults, especially young women living in the north of England, may explain these trends. Recent banning of sunbed use in those under 18 years of age in the UK should eventually bring a reduction in harmful exposure to artificial UV in the future, however, this regulation will not completely resolve the issue as it applies only to commercial outlets so private use remains unregulated and its effects may continue to be seen. It is important to monitor both UV exposure patterns and melanoma incidence closely in the wake of these trends and the recently implemented legislation.”
The study examined diagnoses of melanoma over eleven years (1996 to 2006 inclusive). Melanoma is the least common but most deadly type of skin cancer and the primary cause is exposure to ultraviolet light through sunlight or tanning beds.

Earlier this year, another study in the British Journal of Dermatology revealed that nine out of 10 tanning beds in England are breaking safety rules and giving off radiation levels that are up to six times higher than Mediterranean sunlight.

Skin cancer is the UK’s most common cancer, with over 100,000 new cases diagnoses annually. Melanoma, the least common but most dangerous form of the disease, accounts for 12,800 of these new cases every year, and 2,700 deaths. In Britain, melanoma incidence rates have more than quadrupled over the last 30 years, and the numbers continue to rise.

Notes to editors:
1. For more information and interview requests, please contact: Nina Goad or Deborah Mason, British Association of Dermatologists, Phone: 0207 391 6355, Email: comms@bad.org.uk, Website: www.bad.org.uk

2. If using this information, please ensure you mention that the study is being released in the British Journal of Dermatology, the official publication of the British Association of Dermatologists.

3. Study details: Regional melanoma incidence in England, 1996-2006: reversal of north-south latitude trends among young females
S.C. Wallingford1, 2, R.D. Alston2, J.M. Birch2, A.C. Green1,3
1 Institute of Inflammation & Repair, University of Manchester, Manchester Academic Health
Science Centre, UK
2 Cancer Research UK Paediatric & Familial Cancer Research Group, Institute of Cancer
Sciences, University of Manchester, Manchester Academic Health Science Centre, UK
3 Cancer & Population Studies Group, Queensland Institute of Medical Research, Brisbane,
Australia
Print publication date TBC; Draft, unedited version due to appear in Accepted Articles section online. DOI: 10.1111/bjd.12460. Articles in the BJD can be viewed online: www.brjdermatol.org

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease. For further information about the charity, visit www.bad.org.uk . Wiley-Blackwell, created in February 2007 by merging Blackwell Publishing with Wiley's Global Scientific, Technical, and Medical business, is now one of the world's foremost academic and professional publishers and the largest society publisher. With a combined list of more than 1,400 scholarly peer-reviewed journals and an extensive collection of books with global appeal, this new business sets the standard for publishing in the life and physical sciences, medicine and allied health, engineering, humanities and social sciences. For more information visit www.wiley.com

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