Study of atopic dermatitis in adults and its correlation with perceived stress

Objectives: Atopic dermatitis (AD) is a chronic inflammatory skin disorder that significantly impacts patients’ quality of life (QoL). While it commonly begins in childhood, a considerable number of cases also emerge in adulthood, often without a prior atopic history. Psychological stress has been implicated in exacerbating disease severity, but limited data exist on this relationship in the Indian adult population. This study aimed to evaluate the clinical spectrum of adult AD, assess its correlation with perceived stress and biomarkers such as serum immunoglobulin E (IgE), cortisol, and C-reactive protein (CRP), and determine the association of these parameters with disease severity. Materials and Methods: A hospital-based case–control study was conducted involving 63 adult AD patients and 32 age- and sex-matched controls. Diagnosis was based on Hanifin and Rajka criteria. Disease severity was assessed using scoring atopic dermatitis (SCORAD); perceived stress was measured through the perceived stress scale (PSS). Serum levels of IgE, cortisol, and CRP were analyzed. Results: Elevated IgE levels were significantly associated with higher SCORAD scores (r = 0.58, p <0.01) and higher PSS scores (r = 0.61, p <0.01). A significant correlation was also noted between SCORAD and PSS (r = 0.49, p <0.05). No significant correlation was observed between cortisol or CRP levels and disease severity or stress. Notably, 73% of patients experienced high perceived stress. Conclusion: Adult-onset AD may present independently of traditional atopic history. Elevated IgE and high perceived stress are significantly associated with disease severity. Screening for psychological stress should be an integral part of AD management.