BMJ  2004;328 (22 May), doi:10.1136/bmj.328.7450.0

Infections increase the risk of atopic dermatitis

Infectious diseases in the first six months of life increase the risk of atopic dermatitis. Analysing 24 341 mother-child pairs, Benn and colleagues (p 1223) found that the risk of atopic dermatitis increased with each infectious disease, and decreased with exposure to siblings, day care, pet ownership, and farm residence. These findings challenge the hygiene hypothesis, which holds that infectious diseases protect against allergic diseases. Better hygiene decreases the production of regulatory T cells, resulting in the emergence of allergies, says Watts in a commentary (p 1226); preliminary attempts at vaccination are based on stimulating the production of these T cells.

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