Inclusion Criteria

1. Paediatric and adult patients with atopic eczema who due to the severity of their disease and/or impact on quality of life are commencing on or switching to another systemic immuno-modulatory agent (e.g. CyA, AZA, MTX or biologic treatments).
2. Written informed consent for study participation obtained from the patient or parents / legal guardian, with assent as appropriate by the patient, depending on the level of understanding.
3. Participants consent to participate in long-term follow up and access to all medical records, including hospital admission records and linkage to data held by NHS bodies or other national providers of healthcare data.
4. Diagnosis of atopic eczema in keeping with the UK/Irish diagnostic criteria.
5. Willingness to comply with all study requirements.
6. Competent use of English language, according to patient’s age (capable of understanding patient questionnaires). There is no upper or lower age limit for participation. The decision to start systemic therapy or switch to another systemic agent will be the result of the treating dermatology consultant’s decision, following discussion with the patient/parent/legal guardian, without using a pre-specified severity score cut off. It is the treating physician’s responsibility to ensure that patients are suitable for the therapy, and that any standard of care treatment or assessments are provided alongside participation in the study as per local requirements.

Exclusion Criteria

1. Insufficient understanding of the study by the patient and/or parent/guardian.
2. Patients who are currently participating in a randomised clinical trial.