Real-world eczema phenotypes: Evaluation of longitudinal severity trends from an eczema mobile health app

Summary: This study evaluated longitudinal patterns of eczema severity among EczemaWise users between March 12, 2019 and March 1, 2025 and classified users into real-world eczema phenotypes of disease expression. EczemaWise is a mobile health app (mHealth) that supports patient and caregiver monitoring of eczema symptoms and care conversations with healthcare providers through the collection of patient-reported data. A total of 885 users, each with more than three POSCORAD data points over at least two months, were analyzed. The identified cohort was predominantly female (77.29%), white (62.15%), metropolitan (87.34%), and patient users (88.70%, vs. caregivers). Patients were classified as 'mild' (85 users), 'moderate' (121 users), or 'severe' (51 users) if all recorded scores remained within those respective categories. Users were categorized as 'mild with moderate flares' (126 users) or 'moderate with severe flares' (71 users) if their scores were mostly in the lower category but spiked at least twice into the higher category. 'Seasonally mod-severe' users exhibited recurring seasonal fluctuations between moderate and severe (118 users). Users whose data did not fit these classifications were labeled 'uncategorized' (313 users). Notably, the uncategorized group comprised the largest subset, suggesting that many individuals exhibit fluctuating or atypical patterns that defy conventional classification; this sizable segment may indicate an unmet need for refined or additional metrics to capture the full spectrum of disease variability. Statistical analyses revealed significant differences in severity distribution across demographic subgroups, with race being statistically significant (p<0.05), highlighting potential disparities in disease expression and management. These findings underscore the utility of mHealth platforms not only in monitoring disease progression but also in contributing to a re-evaluation of current categorization frameworks to better understand disease journeys, tailor interventions, and improve patient outcomes. Bryan Mantell¹, Isabelle Thibau¹, Wendy Smith Begolka¹ 1. National Eczema Association, San Rafael, CA, United States. Minoritized Populations and Health Disparities Research