Patient-reported aggravating factors with AD
In this study, 14783 patients (87.8%) did not report any aggravating factors, whereas 1953 patients (11.6%) reported 1 or more aggravating factors. Seasonal aggravating factors including spring, summer, and winter affected a significant proportion of patients with severe AD. Freshwater fish and shellfish, ocean fish and shellfish, lamb and beef, chili peppers, and alcohol were among the aggravating food-related factors. For environmental risk factors, sunlight, humidity, dryness, sweat, shower, rub, dust, and pollen are studied, which all contributed to severe AD. Aggravating psychological factors, including stress, emotional problems, and sleep disorders, were observed in patients with severe AD.The above results are presented in Table 3.
The association between AD severity and seasonal aggravating factors was significant in patients who reported summer as a seasonal risk factor (OR, 1.23, 95%CI: 1.04-1.46, P=0.014) (Table 3). The association between AD severity and food-related aggravating factors was significant in patients who reported freshwater fish and shellfish (OR, 1.77, 95%CI: 1.35-2.33, P<0.001), ocean fish and shellfish (OR: 1.61, 95%CI: 1.33-1.96, P<0.001), lamb and beef (OR, 2.01, 95%CI: 1.59-2.56, P<0.001), chili peppers (OR, 1.52, 95%CI: 1.19-1.95, P=0.001), and alcohol (OR, 1.83, 95%CI: 1.36-2.48, P<0.001) as aggravating factors (Table 3). The association between AD severity and environmental aggravating factors was significant in patients who reported sunlight (OR: 1.79, 95%CI: 1.42-2.25, P<0.001), humidity (OR, 1.61, 95%CI: 1.23-2.11, P=0.001), sweat (OR, 1.27, 95%CI: 1.08-1.48, P=0.004), shower (OR, 1.63, 95%CI: 1.26-2.11, P<0.001), rub (OR, 1.84, 95%CI: 1.37-2.46, P<0.001), dust (OR, 1.55, 95%CI: 1.24-1.92, P<0.001), and pollen (OR, 2.15, 95%CI: 1.54-3.00, P<0.001) as aggravating factors (Table 3). The association between AD severity and psychological aggravating factors was significant in patients who reported stress (OR, 1.99, 95%CI: 1.59-2.50, P<0.001), emotional problem (OR, 1.80, 95%CI: 1.44-2.26, P<0.001), and sleep disorder (OR, 1.89, 95%CI: 1.49-2.41, P<0.001) as aggravating factors (Table 3).