Frontiers in allergy · 2026
IgE-defined endotypes reveal distinct clinical profiles of prurigo nodularis compared with atopic dermatitis: a multicenter study in China.
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Ling Shihua, Liao Yan, Chen Chaofeng, Wu Ruimiao, Yin Mengting, Wei Lu, Chen Jiaying, Huang Haiyan, Dou Xia
Аннотация
BACKGROUND: Prurigo nodularis (PN) is a chronic inflammatory dermatosis that often coexists with atopic dermatitis (AD) but represents a distinct entity. Evidence directly comparing PN and AD in Chinese populations remains limited.
OBJECTIVES: To characterize clinical distinctions between PN and AD in Chinese adults and to explore whether total serum immunoglobulin E (IgE) status delineates distinct clinical profiles within PN.
METHODS: This multicenter case-control study enrolled 2,621 adult patients (≥18 years) including 1,462 with PN and 1,159 with AD. Multivariable logistic regressions were used to evaluate independent associations differentiating PN from AD and to examine IgE-defined clinical heterogeneity within PN.
RESULTS: Compared with AD, PN was independently associated with middle age, rural residence, lower education, smoking, and an overall reduced atopic profile, and was more frequently accompanied by type 2 diabetes mellitus and psychiatric disorders. Within PN, the IgE-high subgroup displayed a pronounced type 2 immune response-associated inflammatory profile, including peripheral eosinophilia and allergen sensitization, whereas IgE-normal patients showed comparatively attenuated atopic markers. In contrast, sociodemographic correlates that distinguished PN from AD were not consistently different between IgE-defined PN subgroups.
CONCLUSIONS: In Chinese adults, PN exhibits clinical heterogeneity with two distinct patterns: one characterized by variability in type 2 immunity-associated and atopic features, and the other by a substantial burden of specific sociodemographic and metabolic comorbidities. Serum IgE may serve as a practical marker for stratifying type 2 immunity and atopic variability in PN.
OBJECTIVES: To characterize clinical distinctions between PN and AD in Chinese adults and to explore whether total serum immunoglobulin E (IgE) status delineates distinct clinical profiles within PN.
METHODS: This multicenter case-control study enrolled 2,621 adult patients (≥18 years) including 1,462 with PN and 1,159 with AD. Multivariable logistic regressions were used to evaluate independent associations differentiating PN from AD and to examine IgE-defined clinical heterogeneity within PN.
RESULTS: Compared with AD, PN was independently associated with middle age, rural residence, lower education, smoking, and an overall reduced atopic profile, and was more frequently accompanied by type 2 diabetes mellitus and psychiatric disorders. Within PN, the IgE-high subgroup displayed a pronounced type 2 immune response-associated inflammatory profile, including peripheral eosinophilia and allergen sensitization, whereas IgE-normal patients showed comparatively attenuated atopic markers. In contrast, sociodemographic correlates that distinguished PN from AD were not consistently different between IgE-defined PN subgroups.
CONCLUSIONS: In Chinese adults, PN exhibits clinical heterogeneity with two distinct patterns: one characterized by variability in type 2 immunity-associated and atopic features, and the other by a substantial burden of specific sociodemographic and metabolic comorbidities. Serum IgE may serve as a practical marker for stratifying type 2 immunity and atopic variability in PN.