Effect of stress on atopic dermatitis: Investigation in patients after the Great Hanshin Earthquake

Background: Although a variety of factors are responsible for atopic dermatitis (AD), very little is known about the effect of stress caused by a natural disaster on AD symptoms. Objective: This study was conducted to assess the effect of stress or trauma on the symptoms of AD. Methods: One thousand four hundred fifty-seven patients with AD (745 males and 712 females), diagnosed by using the criteria of the Japanese Dermatology Association, were enrolled in the study. The data were obtained from a self-administered questionnaire given to patients with AD after experiencing the Great Hanshin Earthquake. The data were analyzed by multivariate logistic regression analysis. Patients were divided into 3 groups: area A, severe damage to buildings and houses; area B, mild damage; and control area, no damage. Results: Exacerbation of skin symptoms was found in 38% and 34% of patients in areas A and B, respectively, whereas similar exacerbation was seen in 7% of control patients. Nine percent and 5% of the patients in areas A and B, respectively, showed improvement in their symptoms compared with 1% in the control group, The earthquake caused stress in 63% and 48% of the patients in areas A and B, respectively, but fewer patients felt stress in undamaged areas (19%). Multiple logistic regression analysis revealed that of the factors examined here, subjective distress is the factor that is most responsible for the exacerbation of skin symptoms (odds ratio, 2.98; 95% confidence interval, 2.25-3.96). Conclusion: The results presented here strongly suggest that stress caused by a natural disaster influences AD symptoms.