Warm, Humid, and High Sun Exposure Climates Are Associated with Poorly Controlled Eczema: PEER (Pediatric Eczema Elective Registry) Cohort, 2004–2012

Sargen, Michael R.; Hoffstad, Ole; Margolis, David J.

doi:10.1038/jid.2013.274

Cited by 73 publications

(74 citation statements)

References 43 publications

(51 reference statements)

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“…A Spanish study of children aged 6 to 7 years found an inverse association between childhood AD and mean annual number of sunny hours [85]. However, a prospective cohort study found greater long-term sun exposure to be associated with poorly controlled disease [88].…”

Section: 42mentioning

confidence: 99%

“…Yet, until recently, there was little evidence to support this notion. One study found that relocating children with AD from the home subarctic/temperate climate of Norway to a subtropical climate in Gran Canary for 4 weeks improved skin symptoms and quality of life [3,[83][84][85][86][87][88]. The climate in a given geographic location is determined by a combination of multiple factors, including temperature, humidity, and precipitation, as well as related factors, such as ultraviolet (UV) exposure.…”

Section: Climatementioning

confidence: 99%

“…However, studies from cohorts in Brazil and the United States found that higher temperatures are associated with poorly controlled AD [87,88]. Heat may play a harmful role in some AD patients by provoking perspiration, which is one of the most commonly reported aggravants in children with AD [139][140][141][142][143].…”

Section: Climatementioning

confidence: 99%

“…Heat may play a harmful role in some AD patients by provoking perspiration, which is one of the most commonly reported aggravants in children with AD [139][140][141][142][143]. Perspiration may have an irritant effect on the skin mediated by the acidic pH of sweat, possibly promoting Th-2 inflammation [88], increased cutaneous blood flow due to vasodilation in hot environments [142], and possibly a neuroanatomic mechanism mediated by C nerve fibers [144]. The worsening of AD symptoms by increased temperature likely explains patient preference toward lighter clothing, thereby allowing for better skin ventilation and facilitating heat dissipation [86].…”

Section: Climatementioning

confidence: 99%

“…higher indoor humidity is associated with lower rates of AD [84,90]. However, conflicting results have been found about whether outdoor humidity is positively or inversely associated with AD prevalence [85,87,88,90]. Further epidemiological research on humidity and AD is warranted, particularly because humidifiers are commonly used as an adjunctive treatment by AD patients.…”

Section: 42mentioning

confidence: 99%

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Environmental risk factors and their role in the management of atopic dermatitis

Kantor

Silverberg

2016

Expert Review of Clinical Immunology

278

225

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Introduction-The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.Areas covered-We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.Expert commentary-The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.

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Section: 42mentioning

confidence: 99%

Section: Climatementioning

confidence: 99%

Section: Climatementioning

confidence: 99%

Section: Climatementioning

confidence: 99%

Section: 42mentioning

confidence: 99%

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Environmental risk factors and their role in the management of atopic dermatitis

Kantor

Silverberg

2016

Expert Review of Clinical Immunology

278

225

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Clinicophotobiological Characterization of Photoaggravated Atopic Dermatitis

et al. 2022

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ImportancePhotoaggravated atopic dermatitis (PAD) is estimated to affect 1.4% to 16% of patients with AD but remains poorly characterized with limited published data.ObjectiveTo provide detailed clinical and photobiological characterization of PAD.Design, Setting, and ParticipantsThis case series study used cross-sectional data collected from 120 consecutive patients diagnosed with PAD from January 2015 to October 2019 at a tertiary center referral unit for photobiology.Main Outcomes and MeasuresRoutinely collected standardized clinical and photobiological data were analyzed using descriptive statistics, and regression analysis explored associations between demographic and clinical data.ResultsOf 869 patients who underwent photoinvestigation, 120 (14%) were diagnosed with PAD (69 female [58%]; median age, 45 [IQR, 31-61] years; range, 5-83 years; skin phototypes [SPTs] I-VI). Of these patients, 104 (87%) were adults. All patients had a history of AD, and most (62 of 104 [60%]) presented with sunlight-provoked or photodistributed eczema; median age at photosensitivity onset was 37 years (range, 1-72 years). Past-year Dermatology Life Quality Index score was greater than 10 for 80 of 103 adults (78%), and 82 of 119 (69%) had vitamin D (25-hydroxyvitamin D) level insufficiency or deficiency (<20 ng/mL; to convert ng/mL to nmol/L, multiply by 2.496). Broadband UV radiation provocation test results were positive for 112 patients (93%). In 28 patients (23%) with abnormal monochromator phototest findings, sensitivity occurred to UV-A, UV-B, and/or visible light, and UV-A of 350 ± 10 nm was the most prevalent wavelength. Photopatch test reactions were positive for 18 patients (15%). Patients with SPTs V to VI (31 [26%]) vs SPTs I to IV (89 [74%]) were younger at photosensitivity onset (median age, 24 years [IQR, 15-37 years] vs 40 years [IQR, 25-55 years]; P = .003), were more likely to be female (23 [74%] vs 46 [52%]; P = .03), and had a lower vitamin D status and a higher frequency of abnormal monochromator phototest findings.Conclusions and RelevanceIn this case series study, PAD affected patients with different ages and SPTs and was associated with substantially impaired quality of life. The findings suggest that confirming PAD through phototesting may provide better personalized care for patients through identification of provoking wavelengths, relevant photocontact allergies, and appropriate photoprotection advice.

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