Skin physiological parameters and their association with severe atopic dermatitis in Mongolian children

Background: Atopic dermatitis (AD) is a chronic skin condition that weakens the skin barrier, leading to increased trans-epidermal water loss and reduced skin moisture. Understanding how these changes in the skin barrier relate to AD severity in Mongolian children may offer insights that could apply to other regions facing similar environmental challenges. Methods: A cross-sectional study was conducted at the National Dermatology Center of Mongolia, involving 103 children with AD. Severity was assessed using the SCORAD index, and skin barrier function was measured through TEWL, skin moisture, and pH. Linear regression analyses were conducted, adjusting for age, skin physiological parameters, AD severity characteristics, and total IgE levels. Results: Among the participants, 48.54% were classified as having moderate AD, while 34.95% had severe AD. The mean SCORAD index was 43.19 ± 17.11. In the final adjusted regression analysis, higher TEWL was significantly associated with greater AD severity (non-lesional: B = 0.328, p = 0.004; lesional: B = 0.272, p = 0.007), while skin moisture showed an inverse association (non-lesional: B = −0.771, p < 0.001; lesional: B = −0.218, p < 0.001). The total IgE level was significantly higher in the severe AD group (p = 0.013). Although skin pH initially correlated with AD severity, it did not remain significant in multivariate analysis. Conclusions: This study emphasizes the role of skin barrier function, particularly increased TEWL and reduced moisture, in AD severity among Mongolian children.