Surge in moderate to severe eczema cases shocks Singapore's health community

In Singapore, there has been a notable rise in the cases of moderate to severe atopic eczema, commonly referred to as atopic dermatitis. According to both KK Women’s and Children’s Hospital and the National Skin Centre, the exact numbers are unclear due to the lack of recent studies, but they have observed an increasing number of patients suffering from these severe forms of the skin condition. Atopic eczema typically begins in early childhood, often within the first few weeks or months of life, and affects a significant percentage of the local pediatric population. KKH reports handling around 20 new cases of atopic eczema each day, with approximately 20% to 30% of these cases being classified as moderate to severe. From various studies conducted by the National Skin Centre, about 25% of all eczema cases have been found to be moderate to severe, with 15% being moderate and 10% classified as severe. The common triggers for eczema flares in Singapore include heat, sweat, and dust, while stress is also a significant contributor as highlighted by dermatologist Associate Professor Mark Koh. Interestingly, the occurrence of atopic eczema appears to correlate with socio-economic status, where higher incidence rates are observed in affluent communities. Genetic factors also play a role; children of parents with atopic conditions have a significantly increased risk of developing atopic dermatitis. More specifically, if a single parent has an atopic condition, their child faces a 40% to 50% chance of developing the disease. This probability increases to 70% to 80% if both parents are affected. While new treatments are available, their costs can be prohibitive for many patients. Dupilumab, a highly effective injectable treatment, shows a success rate of 95% to 97% in patients by providing significant relief within as little as two weeks. However, each dose costs around $1,000, making it unaffordable for some. Another treatment option, JAK inhibitors, ranges in cost from $400 to $1,200 per month. Many patients revert to using less effective steroid creams and moisturizers due to financial constraints. Some patients emphasize the need for more affordable medication options and the inclusion of treatments for moderate to severe eczema in subsidy programs to alleviate the financial burden. The ongoing discussions around healthcare policies may ultimately determine if eczema will be classified under the Chronic Disease Management Programme in the future.