534 Association of itch triggers with atopic dermatitis severity, persistence, flares and seasonality in adults

Atopic dermatitis (AD) is associated with heterogeneous triggers of itch, which may impact AD course and severity. We sought to characterize the triggers of itch in adult AD. We performed a prospective dermatology practice-based study using questionnaires and evaluation by a dermatologist (n=334). Thirteen itch triggers were assessed using Patient-Reported Outcomes Measurement Information System® (PROMIS®) Itch-Triggers. Overall, 209 (62.6%) patients reported ≥1 itch trigger in the past week, and 114 (34.1%) having ≥3 itch triggers. The most commonly reported triggers were stress (31.7%), sweat (28.4%), dry air (26.1%), and heat (23.1%). In multivariable linear regression models, number of itch triggers was associated with more severe patient-reported global AD severity, NRS worst-itch, POEM, NRS skin-pain and objective-SCORAD, but not EASI or SCORAD-sleep. Seasonality of AD was associated with distinct itch triggers. In multivariable logistic regression models, number of itch triggers was associated ≤3 months of AD remission during the year, ≥2 AD flares and AD being worse during some seasons. Four patterns of itch triggers were identified using latent-class analysis, each was associated with different clinical characteristics. In conclusion, itch triggers are common and impact the course of AD. Itch triggers are an important endpoint to assess in AD patients.