AD patients seek education on climate-related triggers

Photo by AfroBrazilian via Wikimedia Commons

A new study, published in JMIR Dermatology, has identified a disconnect between how patients with atopic dermatitis (AD) experience climate-related triggers and how often these concerns are addressed in clinical care.

The researchers say their findings underscore a need for tools and strategies to support climate-health conversations in dermatology.

For the study, investigators initially selected 2,164 English-speaking adults with AD seen at the University of California, San Francisco (UCSF) dermatology clinics between Aug. 2023 and Aug. 2024, identified through an electronic health record (EHR) query.

To reduce selection bias, researchers contacted patients via EHR messaging or mailed letters to account for differences in digital health access. Of the patients contacted, 326 expressed interest and became the study population. These patients were sent the study description and a secure Qualtrics link to an online survey.

Of 326 individuals, 207 completed the survey (63.5% response rate). Most individuals (n=166/207, 80.2%, 95% CI 74.8%‐85.6%) reported that environmental-climate factors impact their AD, particularly extreme heat (n=157, 75.8%, 95% CI 70.0%‐81.7%) and poor air quality (n=81, 39.1%, 95% CI 32.5%‐45.8%).

Commonly reported effects included increased medication use (n=168, 81.2%, 95% CI 75.8%‐86.5%), more symptomatic flares (n=167, 80.7%, 95% CI 75.3%‐86.1%), more skin affected (n=139, 67.1%; 95% CI 60.8%‐73.5%), and changes to daily behaviours (n=130, 62.8%; 95% CI 56.2%‐69.4%).

Most participants (n=179, 86.5%; 95% CI 81.8%‐91.1%) expressed interest in understanding how environmental-climate factors affect their AD, yet only 76 participants (36.7%; 95% CI 30.1%‐43.3%) said their dermatologist addressed these concerns. The most valued strategies for addressing climate-health impacts included more information (n=164, 79.2%; 95% CI 73.7%‐84.8%), dedicated time during visits to plan for exposures (n=105, 50.7%; 95% CI 43.9%‐57.5%), and more in-person visits (n=101, 48.8%; 95% CI 42.0%‐55.6%).

The authors conclude that integrating environmental health into AD management can enhance patient-centred care, improve outcomes, and reinforce dermatology’s role at the intersection of clinical care, public health, and patient advocacy.