Association of Skin Dryness and Disease-related Parameters with Mechanical Alloknesis in Atopic Dermatitis: A Crosssectional and Prospective Cohort Study
DOI:
https://doi.org/10.2340/actadv.v106.adv-2025-0246Keywords:
observational study, atopic dermatitis, pruritus, chemokine CCL17, dupilumabAbstract
Mechanical alloknesis (MA), namely itch hypersensitivity evoked by normally innocuous mechanical stimuli, may exacerbate the itch–scratch cycle in atopic dermatitis (AD). Although various molecular and neural pathways have been identified in animal models, the clinical mechanisms underlying MAmechanical alloknesis remain unclear, particularly in relation to disease severity and biomarkers. We hypothesized that AD atopic dermatitis severity-related parameters are associated with MAmechanical alloknesis. To investigate this, we performed a cross-sectional study comparing healthy controls and ADatopic dermatitis patients, and a prospective cohort study evaluating ADatopic dermatitis patients receiving dupilumab. In the cross-sectional study, MAmechanical alloknesis scores were significantly higher in lesional than in non-lesional or healthy skin. Skin dryness parameters (transepidermal water loss and stratum corneum hydration) showed no significant correlation with MAmechanical alloknesis. Among serum biomarkers, only thymus and activation-regulated chemokine (TARC) levels showed a moderate positive correlation with MAmechanical alloknesis but not with spontaneous itch. In the prospective study, dupilumab significantly reduced eosinophil counts, IgE, TARC, spontaneous itch, and MAmechanical alloknesis scores, although TARC remained correlated with MAmechanical alloknesis after treatment. These findings suggest that TARC may be involved in the induction of MAmechanical alloknesis and represent a potential biomarker or therapeutic target for MAmechanical alloknesis in ADatopic dermatitis.
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