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Comorbidities in childhood atopic dermatitis: a population-based study
Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Lund, Sweden.
Inflammation and Immunology, Pfizer AB, Stockholm, Sweden; Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Dermatology and Sexual Health, Södersjukhuset, Stockholm, Sweden; Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Inflammation and Immunology, Pfizer Inc., PA, Collegeville, United States.
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2024 (English)In: Journal of the European Academy of Dermatology and Venereology, ISSN 0926-9959, E-ISSN 1468-3083, Vol. 38, no 2, p. 354-364Article in journal (Refereed) Published
Abstract [en]

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease that is associated with allergic comorbidities. However, studies examining comorbidities in childhood AD are incomplete, which may contribute to suboptimal care.

Objective: The objective was to compare the risk of developing different allergic and non-allergic comorbidities among children with AD to that of a matched non-AD reference cohort in Sweden.

Methods: This was a nationwide population-based cohort study using longitudinal data from primary and specialist care registers. Patients with AD were identified by confirmed diagnosis in primary or specialist care. The non-AD reference cohort was randomly drawn from the general population and matched 1:1 with the AD patients. The risk of developing the following conditions was evaluated: hypersensitivity and allergic disorders, neurological disorders, psychiatric disorders, infections, immunological and inflammatory disorders, Type 1 diabetes (T1D), endocrine and metabolic disorders, skeletal disorders, ocular disorders and malignancies.

Results: This study included 165,145 patients with AD (mild-to-moderate [n = 126,681] and severe [n = 38,464]) and an equally sized reference cohort. Patients with AD displayed a higher risk of developing comorbid conditions for all investigated categories, except for T1D and skeletal disorders, compared with the reference cohort. The highest risk compared with the reference cohort was observed for hypersensitivity and allergic disorders (hazard ratio [HR]: 3.87), followed by malignancies (HR: 2.53) and immunological and inflammatory disorders (HR: 2.36). Patients with AD also had higher risk of developing multiple comorbidities (≥2). The risk of comorbidity onset increased alongside AD severity and patients with active AD were associated with increased risk of comorbidity onset compared with patients in remission.

Conclusions: The clinical burden of AD is substantial for children with AD and patients are at an increased risk of developing several comorbid conditions extending beyond the atopic march. Our results also showed a positive association between worsening severity of AD and an increased risk of comorbidity onset.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024. Vol. 38, no 2, p. 354-364
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Dermatology and Venereal Diseases
Identifiers
URN: urn:nbn:se:umu:diva-215959DOI: 10.1111/jdv.19569ISI: 001093703100001PubMedID: 37824103Scopus ID: 2-s2.0-85174597101OAI: oai:DiVA.org:umu-215959DiVA, id: diva2:1808135
Available from: 2023-10-30 Created: 2023-10-30 Last updated: 2024-04-26Bibliographically approved

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Geale, Kirk

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