Perceived triggers of atopic dermatitis: Differences by disease severity and race/ethnicity

Summary: Abstract Body: Inequitable experiences of the environment contribute to existing racial and ethnic disparities in atopic dermatitis (AD) burden. We aimed to identify perceived triggers of AD among adults with the skin disease to guide the patient-centered design of research on environmental exposures relevant to AD. A qualitative study of adults with AD in Philadelphia was performed using freelisting, a technique that identifies how people with shared experiences think about a topic. Participants listed triggers of their AD, and words were grouped into categories. Smith’s Salience index (S) was calculated to identify the most important categories; relative salience (RS; a category’s S divided by the maximum S among all categories expressed as a percentage) allowed comparisons across AD severity and racial/ethnic groups. The study included 46 adults with AD (15 White, 16 Black, 15 Hispanic). Median (interquartile range) age was 34 (28, 41) years, 72% were female, and 63% had moderate/severe AD. Overall, "weather" (e.g., heat, cold) was the most salient trigger, followed by “allergies & irritants” (e.g., pollen, chemicals; RS 79%), “other exposures” (e.g., water, air quality; RS 59%), and “personal care products” (e.g., lotions, perfumes; RS 44%). Among mild and moderate/severe AD groups, "weather" was the most salient trigger. For moderate/severe AD, "other exposures" (RS 97%) and "allergies & irritants" (RS 96%) were also highly salient. Across racial/ethnic groups, "weather" was a shared highly salient trigger (RS 92%, 100%, 100% for White, Black, and Hispanic adults, respectively). Among White adults, “other exposures” was also salient (RS 100%), while among Black and Hispanic adults, “allergies & irritants” were prominent (RS 75% and 94%, respectively). Our study identified participant-derived AD triggers and differences by disease severity and race/ethnicity that are important to adults living with AD and necessary to inform patient-centered care and research that includes the patient voice. W Pastard¹, H Gebru¹, L Bou Delgado^{1, 2}, N Martinez O'neill¹, M Rivera Benito¹, FK Barg¹, Junko Takeshita¹ 1. University of Pennsylvania, Philadelphia, PA, United States. 2. Universidad Central del Caribe School of Medicine, Bayamón, Bayamón, Puerto Rico. Minoritized Populations and Health Disparities Research