Immune and environmental predictors of disease severity in atopic dermatitis: a retrospective cohort study

To explore the clinical and epidemiologic characteristics of atopic dermatitis (AD) and their correlation with lesion severity.

A total of 3,912 patients with AD were enrolled in this analysis. Statistical analyses included the chi-square test and multivariate logistic regression to identify independent risk factors.

The incidence was higher in patients under 10 years old and those with onset in autumn. The primary inducing factors varied with disease severity: hot water bathing (mild cases), seasonal changes/dust mites (moderate cases), and seasonal changes/pet contact (severe cases). The main clinical manifestations were pruritus and xerosis cutis. Elevated eosinophils and increased immunoglobulin E (IgE) levels were observed. Multivariate regression analysis identified elevated IgE levels (OR = 3.41), pet contact (OR = 3.25), elevated eosinophils (OR = 2.95), and seasonal variation (OR = 2.18) as significant independent risk factors for disease exacerbation.

AD severity is independently associated with specific immune biomarkers and environmental exposures, targeted intervention, thus offering a basis for risk stratification and targeted clinical management.