Association between yearlong air pollution and moderate-severe atopic dermatitis: A United States cross-sectional claims analysis
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To the Editor: Atopic dermatitis (AD) is a chronic, pruritic inflammatory skin disease affecting over 7% of US adults, with 40% having moderate-severe disease.1 Air pollution, specifically particulate matter ≤2.5 μm (PM2.5), has been associated with AD development among healthy individuals.2 In regional studies, short-term air pollution greatly exceeding Environmental Protection Agency (EPA) standards were associated with flaring of AD symptoms.3 However, most US individuals chronically live at PM2.5 levels within EPA standards,4 and it is unclear how yearlong pollution at these regulated levels affects AD severity nationwide.
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Studies on atopic dermatitis severity showed a significant increase in atopic dermatitis symptom severity with an increase in PM10, NO2, and O3.
“These studies showed a significant increase in AD symptom severity with an increase in PM10, NO2, and O3 [19, 41, 57].”
From Air Pollution and Skin Diseases: A Systematic Review of Epidemiological Evidence (2026) · cites this paper as [57]
Table II supports a significant association between higher O3 and moderate-severe AD. It does not support an increase with PM10 (P=.400), and its significant NO2 association runs in the opposite direction (odds ratio 0.991). The study measured moderate-severe AD using treatment claims rather than symptom severity directly. (LLM, conf=0.91)
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Cites
Association of Wildfire Air Pollution and Health Care Use for Atopic Dermatitis and Itch
Fadadu, R. P., Grimes, B., Jewell, N. P., Vargo, J., Young, A. T., Abuabara, K., Balmes, J. R., & Wei, M. L. (2021) · JAMA Dermatology · doi:10.1001/jamadermatol.2021.0179 · Cited by 120 · cited 2× · see citing works
“In regional studies, short-term air pollution greatly exceeding Environmental Protection Agency (EPA) standards were associated with flaring of AD symptoms.(3) However, most US individuals chronically live at PM2.”
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Research works printed but not linked: 3
- [1]Fuxench Z.C.C. Block J.K. Boguniewicz M. Atopic dermatitis in America study: a cross-sectional study examining the prevalence and disease burden of atopic dermatitis in the US adult population J Invest Dermatol 139 3 2019 583 590 10.1016/j.jid.2018.08.028 30389491 · DOI
- [2]Park S.K. Kim J.S. Seo H.M. Exposure to air pollution and incidence of atopic dermatitis in the general population: a national population-based retrospective cohort study J Am Acad Dermatol 87 6 2021 1321 1327 10.1016/j.jaad.2021.05.061 34242692 · DOI · Paper page
- [5]Fulton R.L. Mitra N. Chiesa-Fuxench Z. Sockler P.G. Margolis D.J. Untapping the potential of utilizing electronic medical records to identify patients with atopic dermatitis: an algorithm using ICD-10 codes Arch Dermatol Res 314 5 2021 439 444 10.1007/s00403-021-02251-w 34081192 · DOI
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Air Pollution and Skin Diseases: A Systematic Review of Epidemiological Evidence
Singh, N., Schikowski, T., & Krutmann, J. (2026) · American Journal of Clinical Dermatology · doi:10.1007/s40257-026-01006-5 · Cited by 4 · see citing works
“These studies showed a significant increase in AD symptom severity with an increase in PM 10 , NO 2 , and O 3 [19, 41, 57].”
- Authors
- Trinh, P., Allerup, J. A. C., Li, S., Ko, J., Chen, J., Linos, E., & Chiou, A. S.
- Affiliations
- Stanford Medicine (US)
- Corresponding author
- Chiou, Albert S.
- Venue
- JAAD International
- Publisher
- Elsevier BV
- Published
- 2023-12
- Volume
- 13
- Pages
- 4-6
- ISSN
- 2666-3287 (ISSN-L)
- PMC
- PMC10430148
- OpenAlex
- W4383215329
- Cited by
- 4
- References
- 1
- Citations by year
- 2026: 2 · 2025: 2
- FWCI
- 0.46
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- JAAD International (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Lundbeck Foundation
- National Institutes of Health
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Keywords
- atopic dermatitis, air pollution, particulate matter, PM2.5, disease severity, EPA air quality standards, long-term exposure
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