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

Background: Although a variety of factors are responsible for atopic dermat itis (AD), very little is known about the effect of stress caused by a natu ral disaster on AD symptoms. Objective: This study was conducted to assess the effect of stress or traum a 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 Dermatolo gy Association, were enrolled in the study. The data were obtained from a s elf-administered questionnaire given to patients with AD after experiencing the Great Hanshin Earthquake. The data were analyzed by multivariate logis tic regression analysis. Patients were divided into 3 groups: area A, sever e 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 th e control group, The earthquake caused stress in 63% and 48% of the patient s in areas A and B, respectively, but fewer patients felt stress in undamag ed areas (19%). Multiple logistic regression analysis revealed that of the factors examined here, subjective distress is the factor that is most respo nsible for the exacerbation of skin symptoms (odds ratio, 2.98; 95% confide nce interval, 2.25-3.96). Conclusion: The results presented here strongly suggest that stress caused by a natural disaster influences AD symptoms.