Abstract
Background:
The role of ultraviolet radiation in atopic dermatitis (AD) is paradoxical, and the relationships between distinct skin phenotypes and AD risk are poorly understood. It is unclear whether skin functional sun reactivity or baseline skin pigmentation is associated with AD susceptibility.
Objective:
To disentangle the independent associations of sun-reactive phototype and pigmentary phenotype with the prevalence of AD in a representative US population.
Methods:
This cross-sectional study analyzed data from 2656 participants in the National Health and Nutrition Examination Survey. We used multivariate logistic regression to calculate odds ratios for AD, adjusting for a comprehensive set of covariates. A multiple imputation sensitivity analysis was performed.
Results:
After full adjustment, less sun-sensitive phototypes were associated with significantly lower odds of AD compared with the most sensitive phototypes. In contrast, the association between pigmentary phenotype and AD was fully attenuated after adjusting for race. Multiple imputation analysis confirmed the robustness of these findings.
Conclusion:
An individual’s functional sun-reactive phototype, but not their constitutional pigmentary phenotype, is independently associated with the risk of AD.
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