A cross-sectional observational study to compare psychosocial impact with stress biomarker level in patients with atopic dermatitis

Atopic Dermatitis (AD), a chronic inflammatory skin condition, affects 10–30% of children and 2–10% of adults in developed countries. This study explored the psychosocial impact of AD, focusing on the relationship between stress biomarkers and disease severity. Sixty participants were included in the current study in which 15 were healthy and 45 had AD which were further equally divided into 3 groups (n = 15), namely, mild, moderate, and severe AD groups using the SCORAD tool. Salivary cortisol levels, depressive symptoms, self-esteem, and quality of life were assessed. A significant positive correlation was found between cortisol levels and SCORAD scores (r = 0.89, p < 0.001), linking increased disease severity with higher stress levels. Greater stress was also associated with more severe depressive symptoms (PHQ9 scores, r = 0.81, p < 0.0001), lower self-esteem, and reduced quality of life (DLQI scores, r = 0.84 for SCORAD and r = 0.88 for cortisol, both p < 0.001). These findings emphasize the heavy psychosocial burden on individuals with severe AD and highlight the need for holistic management. Addressing both physical and psychological aspects, including stress biomarkers like salivary cortisol, may improve treatment outcomes and enhance patients’ overall well-being.