The distinct seasonal attack patterns of childhood atopic dermatitis are associated with various climatic factors

Atopic dermatitis (AD) is a common allergic skin condition in children, with symptom timing and severity varying across individuals. These fluctuations are often influenced by environmental factors. However, prior studies have reported inconsistent associations, with some linking symptoms to heat and others to cold. Few studies have classified children with AD based on seasonal attack patterns.

To identify seasonal subtypes of childhood AD and evaluate their climatic associations.

A nationwide survey was conducted in Taiwan during 2016 to 2017 to assess allergic status, hereditary factors, and living environment conditions among children from 20 elementary and 21 middle schools across the island. Temperature and relative humidity data were collected from nearby air monitoring stations. Among children with current AD, principal component analysis and generalized estimating equations were used to group monthly symptom trends and assess the effects of climatic factors on each subtype.

A total of 11,585 children completed the questionnaire, with 17.6% reporting AD attacks in the past year. Four distinct patterns were identified: spring, summer/fall, winter, and seasonal-overlap. The spring attack pattern was associated with high humidity, especially during winter; the summer/fall pattern was associated with high temperatures, especially during summer; and the winter pattern was associated with low humidity throughout the year. The seasonal-overlap pattern had no clear climatic association.

Children with AD exhibit distinct seasonal patterns linked to different climatic features, highlighting the need for targeted preventive and therapeutic strategies and possibly reflecting diverse underlying mechanisms.