Kodama A, Horikawa T, Suzuki T, Ajiki W, Takashima T, Harada S, Ichihashi M
Department of Dermatology, Kobe University School of Medicine, Kobe, Japan.
J Allergy Clin Immunol. 1999 Jul;104(1):173-6. doi: 10.1016/s0091-6749(99)70130-2.
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.
This study was conducted to assess the effect of stress or trauma on the symptoms of AD.
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.
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).
The results presented here strongly suggest that stress caused by a natural disaster influences AD symptoms.
尽管多种因素可导致特应性皮炎（AD），但关于自然灾害造成的压力对AD症状的影响却知之甚少。
本研究旨在评估压力或创伤对AD症状的影响。
采用日本皮肤病协会的标准诊断出1457例AD患者（男性745例，女性712例）纳入本研究。数据来自阪神大地震后给予AD患者的一份自填式问卷。通过多因素逻辑回归分析对数据进行分析。患者分为3组：A区，建筑物和房屋严重受损；B区，轻度受损；以及对照区，未受损。
A区和B区分别有38%和34%的患者皮肤症状加重，而对照区患者中出现类似加重情况的为7%。A区和B区分别有9%和5%的患者症状有所改善，而对照组为1%。地震分别给A区和B区63%和48%的患者造成了压力，但在未受损地区感到压力的患者较少（19%）。多因素逻辑回归分析显示，在此处研究的因素中，主观痛苦是导致皮肤症状加重的最主要因素（优势比，2.98；95%置信区间，2.25 - 3.96）。
此处呈现的结果强烈表明自然灾害造成的压力会影响AD症状。
