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. 2025 Aug 25:1-9.
doi: 10.1080/1744666X.2025.2549826. Online ahead of print.

Assessing Atopic Dermatitis severity in children from Georgia: the correlation of inflammatory blood markers to the Eczema Area and Severity Index

Janadi Karawita  1 , Faiza Yasmine Kabachi  1 , Aliya Modak  1 , Arun Venkiteswaran  1 , Rawiah Haseeb  1 , Nikoloz Papiashvili  1 , Kevin Jacob  1 , Veriko Abralava  1
Affiliations

Assessing Atopic Dermatitis severity in children from Georgia: the correlation of inflammatory blood markers to the Eczema Area and Severity Index

Janadi Karawita et al. Expert Rev Clin Immunol. .

Abstract

Background: Atopic dermatitis (AD) is a chronic inflammatory skin condition prevalent among children worldwide. Systemic inflammation is a key factor in its pathophysiology. Correlating blood markers with Eczema Area and Severity Index (EASI) can reveal information about the severity and activity of the disorder, allowing for more focused treatment.

Methods: A retrospective analysis was conducted on 22 patients aged 3 months to 18 years. Blood parameters, such as Eosinophil Relative Count (ERC), Neutrophil/Lymphocyte Ratio (NLR), Eosinophil/Lymphocyte Ratio (ELR), and Basophil/Lymphocyte Ratio (BLR), were correlated with the Eczema Area and Severity Index (EASI).

Results: A strong positive correlation was observed between EASI scores and ERC (r = 0.69, p < 0.001) and with ELR (r = 0.71, p < 0.001). No statistical significance was seen between EASI scores and the NLR (r = 0.2059, p = 0.3578) and BLR (r = 0.1026, p = 0.6494). No significant association was found between age and EASI scores (r = -0.0351, p = 0.8767).

Conclusions: ERC and ELR have the potential to serve as objective blood markers for assessing AD severity. However, more research in pediatric populations with a larger sample size is needed to establish a conclusive association for clinical practice.

Keywords: Atopic Dermatitis; Blood Biomarkers; Disease Monitoring; Eczema Area and Severity Index; Eosinophil Markers; Eosinophil Relative Count; Eosinophil-to-Lymphocyte Ratio; Pediatric Dermatology.

Plain language summary

Atopic dermatitis (AD) is a chronic skin condition that causes inflammation and itching. The Eczema Area and Severity Index (EASI) is a tool used by clinicians to assess the clinical severity of atopic dermatitis (AD). Since the EASI relies on clinical observation, we investigated whether blood markers could provide a more objective measure of disease severity. We analyzed blood test results from 22 pediatric patients in Georgia, comparing the EASI with eosinophil relative count (ERC), eosinophil-to-lymphocyte ratio (ELR), neutrophil-to-lymphocyte ratio (NLR), and basophil-to-lymphocyte ratio (BLR). ERC and ELR increased as EASI scores rose, indicating a clear relationship between these markers and disease severity. These findings suggest that ERC and ELR could serve as objective measures of AD severity, potentially reducing reliance on subjective clinical assessments. Integrating these markers into routine practice may improve disease monitoring, but larger studies in pediatric populations are needed to validate their reliability.

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