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

OBJECTIVE: To explore the clinical and epidemiologic characteristics of atopic dermatitis (AD) and their correlation with lesion severity. METHODS: 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. RESULTS: 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. CONCLUSION: 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.