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  • 1.
    Danielsson, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Boldrup, Linda
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Rentoft, Matilda
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Coates, Philip
    Tayside Tissue Bank/Medical Research Institute, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK.
    Ebrahimi, Majid
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Nylander, Elisabet
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Dermatologi och venereologi.
    Wahlin, Ylva Britt
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Nylander, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Autoantibodies and decreased expression of the transcription factor ELF-3 together with increased chemokine pathways support an autoimmune phenotype and altered differentiation in lichen planus located in oral mucosa2013Ingår i: Journal of the European Academy of Dermatology and Venereology, ISSN 0926-9959, E-ISSN 1468-3083, Vol. 27, nr 11, s. 1410-1416Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background  The pathogenesis of oral lichen planus (OLP), a chronic inflammatory disease, is not fully understood. It is known that OLP has autoimmune features, and it is suggested to be an autoimmune disease. ELF-3 is involved in differentiation of keratinocytes and deregulated in different tumours and inflammatory diseases. CXCR-3 and its ligands CXCL-10 and CXCL-11 are increased in autoimmune diseases and linked to Th-1 immune response. Objectives  To analyse and compare expression of ELF-3, CXCR-3, CXCL-10 and CXCL-11 in OLP lesions and controls in whole and microdissected epithelium. Methods  Tissue biopsies from 20 patients clinically and histologically diagnosed with OLP and 20 healthy controls were studied using whole tissues or microdissected epithelium. By the use of qRT-PCR, mRNA levels of ELF-3, CXCR-3, CXCL-10 and CXCL-11 were studied. Western blot was used for analysis of ELF-3 protein expression. Sera from 19 OLP patients and 20 controls were analysed with ELISA in search for autoantibodies. Results  The upregulation of CXCR-3, CXCL-10 and CXCL-11 found in OLP is similar to previous findings showing an autoimmune phenotype in lichen planus (LP) and lichen sclerosus. Decreased expression of the differentiation-related transcription factor ELF-3 was also seen in OLP lesions, and we further demonstrate presence of circulating autoantibodies against the ELF-3 protein in sera from 3 of 19 (16%) LP patients tested. Conclusions  On the basis of these findings, we confirm that OLP shows features of an autoimmune disease and suggest deregulated differentiation of keratinocytes to be one of the causes of the disease phenotype.

  • 2.
    Danielsson, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Ebrahimi, Maijd
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Wahlin, Ylva-Britt
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi.
    Nylander, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Boldrup, Linda
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Increased levels of COX-2 in oral lichen planus supports an autoimmune cause of the disease2012Ingår i: Journal of the European Academy of Dermatology and Venereology, ISSN 0926-9959, E-ISSN 1468-3083, Vol. 26, nr 11, s. 1415-1419Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Oral lichen planus (OLP) is a chronic inflammatory disease for which the pathogenesis is not fully understood. OLP has autoimmune features and auto immunity has been suggested as a potential cause, whereas WHO has classified OLP as a premalignant condition. Association between chronic inflammation and cancer is known and chronic inflammation is one of the characteristics of OLP. A protein connected to inflammation and suggested to be involved in cancer development is cyclooxygenase-2 (COX-2) which can be inhibited by microRNA-26b (miR-26b).

    Objective: The aim was to map levels of COX-2 and miR-26b in OLP lesions to see if there was any correlation between expression of COX-2 and its regulator miR-26b in OLP.

    Methods: In biopsies from 20 OLP patients and 20 age and gender-matched controls laser- micro dissection of epithelium was performed. Quantitative RT-PCR, immunohistochemistry and Western blot were used in the analysis.

    Results: Levels of COX-2 mRNA were significantly higher while levels of miR-26b were significantly lower in OLP lesions compared to controls. Using immunohistochemistry normal oral mucosa samples did not show any expression of COX-2 while OLP samples expressed the protein. No COX-2 protein was detectable with Western blot.

    Conclusion: Increased expression of COX-2 and decreased expression of miR-26b in OLP suggests both to play a role in OLP. COX-2 has been connected to both malignant development and autoimmunity but as malignant development of OLP is quite rare we suggest that the increased levels of COX-2 seen here support an autoimmune cause of the disease.

  • 3.
    Danielsson, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral diagnostik.
    Ebrahimi, Majid
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral diagnostik. Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Endodonti.
    Wahlin, Ylva-Britt
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Oral diagnostik. Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Protetik.
    Nylander, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Boldrup, Linda
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Reply to increased levels of COX-2 and oral lichen planus by P.D. Pigatto, F. Spaderi, G.P. Bombeccari, G. Guzzi by Danielsson et al2013Ingår i: Journal of the European Academy of Dermatology and Venereology, ISSN 0926-9959, E-ISSN 1468-3083, Vol. 27, nr 3, s. 395-396Artikel i tidskrift (Refereegranskat)
  • 4. Gyllencreutz, J. Dahlen
    et al.
    Paoli, J.
    Bjellerup, M.
    Bucharbajeva, Zinaida
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Dermatologi och venereologi.
    Gonzalez, H.
    Nielsen, K.
    Sandberg, C.
    Synnerstad, I.
    Terstappen, K.
    Wennberg Larko, A. -M
    Diagnostic agreement and interobserver concordance with teledermoscopy referrals2017Ingår i: Journal of the European Academy of Dermatology and Venereology, ISSN 0926-9959, E-ISSN 1468-3083, Vol. 31, nr 5, s. 898-903Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BackgroundMalignant melanoma and non-melanoma skin cancers are among the fastest increasing malignancies in many countries. With the help of new tools, such as teledermoscopy referrals between primary health care and dermatology clinics, the management of these patients could be made more efficient. ObjectiveTo evaluate the diagnostic agreement and interobserver concordance achieved when assessing referrals sent through a mobile teledermoscopic referral system as compared to referrals sent via the current paper-based system without images. MethodsThe referral information from 80 teledermoscopy referrals and 77 paper referrals were evaluated by six Swedish dermatologists. They were asked to answer questions about the probable diagnosis, the priority, and a management decision. ResultsTeledermoscopy generally resulted in higher diagnostic agreement, better triaging and more malignant tumours being booked directly to surgery. The largest difference between the referral methods was seen for invasive melanomas. Referrals for benign lesions were significantly more often correctly resent to primary health care with teledermoscopy. However, referrals for cases of melanoma in situ were also incorrectly resent five times. The interobserver concordance was moderate with both methods. ConclusionBy adding clinical and dermoscopic images to referrals, the triage process for both benign and dangerous skin tumours can be improved. With teledermoscopy, patients with melanoma especially can receive treatment more swiftly.

  • 5.
    Hägg, David
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Dermatologi och venereologi.
    Sundström, A
    Eriksson, Marie
    Umeå universitet, Samhällsvetenskapliga fakulteten, Handelshögskolan vid Umeå universitet, Statistik.
    Schmitt-Egenolf, Marcus
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Dermatologi och venereologi.
    Decision for biological treatment in real life is more strongly associated with the Psoriasis Area and Severity Index (PASI) than with the Dermatology Life Quality Index (DLQI)2015Ingår i: Journal of the European Academy of Dermatology and Venereology, ISSN 0926-9959, E-ISSN 1468-3083, Vol. 29, nr 3, s. 452-456Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Following the establishment of the National Quality Registry for systemic psoriasis treatment (PsoReg), the two psoriasis outcome measurements, Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI), are now integrated in clinical practice in Sweden. According to current guidelines, the initiation of a biological treatment should depend on a combination of the physician's (PASI) and the patients' assessment of the disease impact on a health-related quality of life measure (DLQI).

    OBJECTIVE: To evaluate if either of the two measures, PASI or DLQI, is more strongly associated with initiation of biological therapy.

    METHODS: The study is based on 2216 patients suffering from moderate to severe psoriasis who were biological naïve at enrolment to PsoReg. The relationship between the two measures PASI and DLQI and initiation of biological treatment (as outcome) were estimated by a logistic regression and a Cox proportional hazard's model with combinations of PASI and DLQI as independent variables.

    RESULTS: The adjusted regression models showed that patients with high PASI score and low DLQI score had a higher chance to receive biological treatment compared to patients with low PASI score and high DLQI score.

    CONCLUSION: The decision to initiate biological treatment is more strongly associated with PASI than with DLQI. However, since the DLQI reflects both socio-economic costs and patient suffering better than PASI, the relevance of the DLQI may be underestimated in clinical practice.

  • 6.
    Jahns, Anika C.
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Lundskog, Bertil
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Nosek, Daniel
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Dermatologi och venereologi.
    Killasli, H.
    Emtestam, L.
    Alexeyev, Oleg A.
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Microbiology of folliculitis decalvans: a histological study of 37 patients2015Ingår i: Journal of the European Academy of Dermatology and Venereology, ISSN 0926-9959, E-ISSN 1468-3083, Vol. 29, nr 5, s. 1025-1026Artikel i tidskrift (Övrigt vetenskapligt)
  • 7. Nast, A.
    et al.
    Smith, C.
    Spuls, P. I.
    Valle, G. Avila
    Bata-Csorgo, Z.
    Boonen, H.
    De Jong, E.
    Garcia-Doval, I.
    Gisondi, P.
    Kaur-Knudsen, D.
    Mahil, S.
    Malkonen, T.
    Maul, J. T.
    Mburu, S.
    Mrowietz, U.
    Reich, K.
    Remenyik, E.
    Ronholt, K. M.
    Sator, P. G.
    Schmitt-Egenolf, Marcus
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Dermatologi och venereologi.
    Sikora, M.
    Stroemer, K.
    Sundnes, O.
    Trigos, D.
    Van der Kraaij, G.
    Yawalkar, N.
    Dressler, C.
    EuroGuiDerm Guideline on the systemic treatment of Psoriasis vulgaris – Part 1: treatment and monitoring recommendations2020Ingår i: Journal of the European Academy of Dermatology and Venereology, ISSN 0926-9959, E-ISSN 1468-3083, Vol. 34, nr 11, s. 2461-2498Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This evidence‐ and consensus‐based guideline on the treatment of psoriasis vulgaris was developed following the EuroGuiDerm Guideline and Consensus Statement Development Manual. The first part of the guideline includes general information on the scope and purpose, health questions covered, target users and strength/limitations of the guideline. Suggestions for disease severity grading and treatment goals are provided. It presents the general treatment recommendations as well as detailed management and monitoring recommendations for the individual drugs. The treatment options discussed in this guideline are as follows: acitretin, ciclosporin, fumarates, methotrexate, adalimumab, apremilast, brodalumab, certolizumab pegol, etanercept, guselkumab, infliximab, ixekizumab, risankizumab, secukinumab, tildrakizumab and ustekinumab.

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  • 8.
    Nast, A.
    et al.
    Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Department of Dermatology, Venereology and Allergology, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
    Smith, C.
    St John's Institute of Dermatology, London, United Kingdom.
    Spuls, P.I.
    Academic Medical Centre Amsterdam, Amsterdam, Netherlands.
    Avila Valle, G.
    Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Department of Dermatology, Venereology and Allergology, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
    Bata-Csörgö, Z.
    University of Szeged, Szeged, Hungary.
    Boonen, H.
    Office-Based Dermatology Practice, Geel, Belgium.
    De Jong, E.
    Radboud University Medical Centre Nijmegen, Nijmegen, Netherlands.
    Garcia-Doval, I.
    Unidad de Investigación. Fundación Piel Sana AEDV, Madrid, Spain.
    Gisondi, P.
    University of Verona, Verona, Italy.
    Kaur-Knudsen, D.
    University Hospital Copenhagen, Copenhagen, Denmark.
    Mahil, S.
    Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
    Mälkönen, T.
    Helsinki University Central Hospital, Helsinki, Finland.
    Maul, J.T.
    Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland.
    Mburu, S.
    International Federation of Psoriasis Associations (IFPA), Germany.
    Mrowietz, U.
    Universitätsklinikum Schleswig-Holstein, Kiel, Germany.
    Reich, K.
    Translational Research in Inflammatory Skin Diseases, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
    Remenyik, E.
    University of Debrecen, Debrecen, Hungary.
    Rønholt, K.M.
    Aarhus University Hospital, Aarhus, Denmark.
    Sator, P.G.
    Municipal Hospital Hietzing, Vienna, Austria.
    Schmitt-Egenolf, Marcus
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Dermatologi och venereologi.
    Sikora, M.
    Department of Dermatology, Medical University of Warsaw, Warsaw, Poland.
    Strömer, K.
    Office-Based Dermatology Practice, Mönchengladbach, Germany.
    Sundnes, O.
    Oslo University Hospital, Oslo, Norway.
    Trigos, D.
    International Federation of Psoriasis Associations (IFPA), Germany.
    Van Der Kraaij, G.
    Academic Medical Centre Amsterdam, Amsterdam, Netherlands.
    Yawalkar, N.
    Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
    Dressler, C.
    Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Department of Dermatology, Venereology and Allergology, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
    EuroGuiDerm Guideline on the systemic treatment of Psoriasis vulgaris – Part 2: specific clinical and comorbid situations2021Ingår i: Journal of the European Academy of Dermatology and Venereology, ISSN 0926-9959, E-ISSN 1468-3083, Vol. 35, nr 2, s. 281-317Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This evidence- and consensus-based guideline on the treatment of psoriasis vulgaris was developed following the EuroGuiDerm Guideline and Consensus Statement Development Manual. The second part of the guideline provides guidance for specific clinical and comorbid situations such as treating psoriasis vulgaris patient with concomitant psoriatic arthritis, concomitant inflammatory bowel disease, a history of malignancies or a history of depression or suicidal ideation. It further holds recommendations for concomitant diabetes, viral hepatitis, disease affecting the heart or the kidneys as well as concomitant neurological disease. Advice on how to screen for tuberculosis and recommendations on how to manage patients with a positive tuberculosis test result are given. It further covers treatment for pregnant women or patients with a wish for a child in the near future. Information on vaccination, immunogenicity and systemic treatment during the COVID-19 pandemic is also provided.

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  • 9.
    Nylander Lundqvist, Elisabet
    et al.
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Dermatologi och venereologi.
    Wahlin, Ylva-Britt
    Umeå universitet, Medicinsk fakultet, Odontologi, Oral diagnostisk radiologi.
    Bergdahl, M
    Umeå universitet, Medicinsk fakultet, Odontologi.
    Bergdahl, Jan
    Umeå universitet, Samhällsvetenskaplig fakultet, Psykologi.
    Psychological health in patients with genital and oral erosive lichen planus2006Ingår i: Journal of the European Academy of Dermatology and Venereology, ISSN 0926-9959, E-ISSN 1468-3083, Vol. 20, nr 6, s. 661-666Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Erosive lichen planus is a severe, recurrent and recalcitrant disease that affects several mucosal areas, mostly the genital area and the mouth, but also, for example, the oesophagus and perianal area. The disease causes serious symptoms, because of the raw, de-epithelialized mucosa and healing with scars/adhesions, which affect the patient's life in many ways. It causes, for example, difficulties in eating, drinking and going to the bathroom. Treatment is complicated and, so far, few therapeutic drugs other than steroids have been reported. OBJECTIVES: As the disease has severe implications on the patient's life it is important to investigate the psychological health of the patients, as well as the influence of stress on their health and wellbeing, in order to improve treatment. STUDY DESIGN, SUBJECTS AND METHODS: Forty-nine consecutive patients with erosive lichen planus were included during a 1-year period. The study was carried out as 'state-of-the-last-month', and stress, state anxiety, depression and 'erosive lichen planus factors', i.e. symptoms affecting daily life, were assessed. RESULTS: Eighty-seven per cent of the patients had symptoms, severely affecting daily life. Unexpectedly, oral symptoms seemed to be the most prominent. Our results showed that depression, anxiety and stress were more common in patients with erosive lichen planus than in a control group. DISCUSSION AND CONCLUSIONS: Erosive lichen planus is a severe disease with symptoms and complications affecting the patient's life. Our results indicate that their psychological health is also affected and emphasize the need for close collaboration between physicians, dentists with special knowledge in oral medicine and counsellors/psychologists to optimize handling of these patients.

  • 10.
    von Kobyletzki, L.
    et al.
    Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Lund, Sweden.
    Ballardini, N.
    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.
    Henrohn, D.
    Pfizer AB, Sollentuna, Sweden; Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Neary, M.P.
    Pfizer Inc., NY, New York, United States.
    Ortsäter, G.
    Quantify Research, Stockholm, Sweden.
    Geale, Kirk
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Dermatologi och venereologi. Quantify Research, Stockholm, Sweden.
    Rieem Dun, A.
    Quantify Research, Stockholm, Sweden.
    Lindberg, I.
    Quantify Research, Stockholm, Sweden.
    De Geer, A.
    Pfizer AB, Sollentuna, Sweden.
    Neregård, P.
    Pfizer AB, Sollentuna, Sweden.
    Cha, A.
    Pfizer Inc., NY, New York, United States.
    Cappelleri, J.C.
    Pfizer Inc., NY, New York, United States.
    Romero, W.
    Inflammation & Immunology, Pfizer Ltd, Surrey, United Kingdom.
    Thyssen, J.P.
    Department of Dermatology and Venereology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
    Care pathways in atopic dermatitis: a retrospective population-based cohort study2022Ingår i: Journal of the European Academy of Dermatology and Venereology, ISSN 0926-9959, E-ISSN 1468-3083, Vol. 36, nr 9, s. 1456-1466Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Atopic dermatitis (AD) is a complex disease with variations in severity and healthcare utilization. Examining patient pathways through analyses of longitudinal patient data provides an opportunity to describe real-world clinical patient care and evaluate healthcare access and treatment.

    Objective: To describe longitudinal care pathways including health care management, treatment patterns and disease progression (by proxy measures) in patients with AD.

    Materials and methods: This was a longitudinal observational study, which used linked data from national and regional healthcare registers in Sweden. Patients with AD were identified through diagnosis in primary or secondary care or by dispensed medications. Descriptive statistics for number of healthcare visits, type of dispensed drug class, rate of - and time to - referral to secondary care and treatment escalation were calculated.

    Results: A total of 341 866 patients with AD distributed as 197 959 paediatric (age < 12), 36 133 adolescent (age ≥ 12- < 18) and 107 774 adult (age ≥ 18) patients were included in this study. Healthcare visits to primary and secondary care and dispensation of AD-indicated treatments were more common during the year in which managed AD care was initiated. Topical corticosteroids (TCSs) and emollients were the most frequently used treatments across all age cohorts while systemic treatment was uncommon in all age cohorts. Among patients who initiated treatment with TCSs, 18.2% escalated to TCSs with higher potency following the start of managed AD care.

    Conclusions: We found that healthcare contacts and use of AD-indicated treatments were concentrated in the year during which managed AD care was initiated and decreased significantly thereafter. Since a significant proportion of patients with AD have flares and persistent AD, our results suggest that patients with AD may be monitored infrequently and are undertreated. There is a need to inform practitioners about adequate treatment options to provide individualized care, in particular for patients with persistent severe AD.

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  • 11.
    von Kobyletzki, Laura
    et al.
    Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Lund, Sweden.
    Henrohn, Dan
    Inflammation and Immunology, Pfizer AB, Stockholm, Sweden; Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Ballardini, Natalia
    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.
    Neary, Maureen P.
    Inflammation and Immunology, Pfizer Inc., PA, Collegeville, United States.
    Ortsäter, Gustaf
    Quantify Research AB, Stockholm, Sweden.
    Rieem Dun, Alexander
    Quantify Research AB, Stockholm, Sweden.
    Geale, Kirk
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Dermatologi och venereologi. Quantify Research AB, Stockholm, Sweden.
    Lindberg, Ingrid
    Quantify Research AB, Stockholm, Sweden.
    Theodosiou, Grigorios
    Department of Dermatology, Skåne University Hospital, Malmö, Sweden.
    Neregård, Petra
    Inflammation and Immunology, Pfizer AB, Stockholm, Sweden.
    De Geer, Anna
    Inflammation and Immunology, Pfizer AB, Stockholm, Sweden.
    Cha, Amy
    Inflammation and Immunology, Pfizer Inc., NY, New York, United States.
    Cappelleri, Joseph C.
    Global Biometrics and Data Management (Statistics), Pfizer Inc., CT, Groton, United States.
    Thyssen, Jacob P.
    Department of Dermatology and Venereology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
    Comorbidities in childhood atopic dermatitis: a population-based study2024Ingår i: Journal of the European Academy of Dermatology and Venereology, ISSN 0926-9959, E-ISSN 1468-3083, Vol. 38, nr 2, s. 354-364Artikel i tidskrift (Refereegranskat)
    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.

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