The American journal of the medical sciences · 2026
Indoor allergen exposure, peripheral blood eosinophil counts, and symptom-defined chronic relapsing pruritic rash: A cross-sectional analysis of NHANES 2005-2006.
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Gan Lu, Sun Yaohui, Gan Hui
Аннотация
BACKGROUND: Chronic relapsing pruritic rash (CRPR) is a common and impactful symptom-defined syndrome encompassing several chronic inflammatory skin conditions, most notably atopic dermatitis (AD). The associations of indoor allergen exposure and peripheral blood eosinophil counts with this syndrome remain unclear.
OBJECTIVE: This study aimed to examine the associations of common indoor allergen concentrations and peripheral blood eosinophil counts with the prevalence and clinical course of CRPR. In this study, CRPR is used solely as a historical, symptom-based operational construct derived from the NHANES 2005-2006 questionnaire, rather than as a contemporary stand-alone clinical diagnosis.
METHODS: We utilized data from the National Health and Nutrition Examination Survey (NHANES) 2005-2006. CRPR was defined as a positive response to the questionnaire item "have you ever had an itchy rash which was coming and going for at least 6 months?". Extracted variables included basic demographic information, concentrations of various indoor allergens, and peripheral blood eosinophil counts. Multivariable logistic regression models were used to analyze the associations between these variables and the prevalence and severity of CRPR.
RESULTS: A total of 6,068 participants were included, of whom 877 (14.4%) met the CRPR criteria. Multivariable regression analysis, adjusted for demographic factors, revealed that higher concentrations of German cockroach allergen (Bla g 1) (OR=1.32, 95% CI: 1.15-1.52, P<0.001) and elevated peripheral blood eosinophil counts (OR=1.58, 95% CI: 1.42-1.76, P<0.001) were independently associated with higher odds of CRPR. Among individuals with CRPR, 81.0% (710/877) had experienced an episode in the past year. In this group, higher concentrations of Alternaria allergen (Alt a 1) were associated with a lower risk of exacerbations, whereas higher concentrations of rat allergen (Rat n 1) were associated with an increased risk. Furthermore, moderate indoor concentrations of mouse allergen (Mus m 1) were associated with a higher likelihood of rash resolution among these individuals.
CONCLUSIONS: In this large U.S. cohort, CRPR was associated with peripheral eosinophilia and German cockroach allergen exposure. These findings suggest that peripheral eosinophilia may represent a relevant inflammatory correlate in a subset of individuals with CRPR, while the observed associations should be interpreted considering the syndrome's diagnostic heterogeneity.
OBJECTIVE: This study aimed to examine the associations of common indoor allergen concentrations and peripheral blood eosinophil counts with the prevalence and clinical course of CRPR. In this study, CRPR is used solely as a historical, symptom-based operational construct derived from the NHANES 2005-2006 questionnaire, rather than as a contemporary stand-alone clinical diagnosis.
METHODS: We utilized data from the National Health and Nutrition Examination Survey (NHANES) 2005-2006. CRPR was defined as a positive response to the questionnaire item "have you ever had an itchy rash which was coming and going for at least 6 months?". Extracted variables included basic demographic information, concentrations of various indoor allergens, and peripheral blood eosinophil counts. Multivariable logistic regression models were used to analyze the associations between these variables and the prevalence and severity of CRPR.
RESULTS: A total of 6,068 participants were included, of whom 877 (14.4%) met the CRPR criteria. Multivariable regression analysis, adjusted for demographic factors, revealed that higher concentrations of German cockroach allergen (Bla g 1) (OR=1.32, 95% CI: 1.15-1.52, P<0.001) and elevated peripheral blood eosinophil counts (OR=1.58, 95% CI: 1.42-1.76, P<0.001) were independently associated with higher odds of CRPR. Among individuals with CRPR, 81.0% (710/877) had experienced an episode in the past year. In this group, higher concentrations of Alternaria allergen (Alt a 1) were associated with a lower risk of exacerbations, whereas higher concentrations of rat allergen (Rat n 1) were associated with an increased risk. Furthermore, moderate indoor concentrations of mouse allergen (Mus m 1) were associated with a higher likelihood of rash resolution among these individuals.
CONCLUSIONS: In this large U.S. cohort, CRPR was associated with peripheral eosinophilia and German cockroach allergen exposure. These findings suggest that peripheral eosinophilia may represent a relevant inflammatory correlate in a subset of individuals with CRPR, while the observed associations should be interpreted considering the syndrome's diagnostic heterogeneity.