Warm, Humid, and High Sun Exposure Climates Are Associated with Poorly Controlled Eczema: PEER (Pediatric Eczema Elective Registry) Cohort, 2004-2012

Anecdotal reports of children experiencing eczema flares during winter and summer months along with global variation in eczema prevalence has fueled speculation that climate may modulate disease activity. The aim of this study was to determine whether long-term weather patterns affect the severity and persistence of eczema symptoms in children. We performed a prospective cohort study of US children (N=5,595) enrolled in PEER (Pediatric Eczema Elective Registry) between 2004 and 2012 to evaluate the effect of climate (daily temperature, daily sun exposure, daily humidity) on the severity of eczema symptoms. Odds ratios (ORs) were calculated for the patient-evaluated outcome of disease control. Multivariate logistic regression modeling adjusting for gender, race, income, and topical medication use demonstrated that higher temperature (OR= 0.90, 95% confidence interval (Cl): 0.87-0.93, P < 0.001) and increased sun exposure (OR= 0.93, 95% Cl: 0.89-0.98, P=0.009) were associated with poorly controlled eczema. Higher humidity (OR= 0.90, 95% Cl: 0.812-0.997, P=0.04) was also associated with poorly controlled disease, but the statistical significance of this association was lost in our multivariate analysis (P = 0.44).