Association between atopic dermatitis and autoimmune disorders in US adults and children: A cross-sectional study

Narla, Shanthi; Silverberg, Jonathan I.

doi:10.1016/j.jaad.2018.09.025

Cited by 65 publications

(89 citation statements)

References 25 publications

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“…In persons with and without AD, the odds of autoimmune diseases have been found to increase throughout childhood into middle age and decline in older age . The differences observed between children and adults could be attributed to the differential changes in T‐helper (Th) 1 and Th2 cytokines with age . This could be the reason for the higher odds in adult AD seen in our analysis.…”

Section: Discussionmentioning

confidence: 56%

“…The study selection process is summarized using the PRISMA flowchart in Figure . A total of seven studies (1 540 688 AD patients) were finally included in our study . Among these, five studies (137 846 AD patients) compared the prevalence of vitiligo in AD patients and controls, while two cohort studies (1 402 842 AD patients) reported the incidence of vitiligo in AD patients.…”

Section: Resultsmentioning

confidence: 99%

“…In comparison with the controls, we found that the odds of vitiligo in adult AD (OR, 4.46; 95% CI, 1.65‐12.07) were higher than the odds of vitiligo in childhood AD (OR, 2.83; 95% CI, 1.53‐5.25). In persons with and without AD, the odds of autoimmune diseases have been found to increase throughout childhood into middle age and decline in older age . The differences observed between children and adults could be attributed to the differential changes in T‐helper (Th) 1 and Th2 cytokines with age .…”

Section: Discussionmentioning

confidence: 99%

“…It is associated with multiple comorbidities including asthma, allergic rhinitis, cardiovascular diseases, inflammatory disorders, and metabolic syndrome . Recent studies of AD have also found its significant association with various autoimmune disorders . Vitiligo is one such immune‐mediated skin depigmentation disorder that can co‐occur with AD and add to the psychosocial burden of the patient.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, the earlier study was limited by small sample size (2 studies with 823 vitiligo patients and 192 controls) available for analysis . Since then, multiple large studies that have assessed the association between AD and vitiligo have been conducted . Considering the potential clinical and therapeutic implications of the association, we aimed to assess the prevalence and risk of vitiligo in patients with AD through this study.…”

Section: Introductionmentioning

confidence: 99%

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Association of atopic dermatitis with vitiligo: A systematic review and meta‐analysis

Acharya

Mathur

2019

J of Cosmetic Dermatology

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Background Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with multiple immune‐mediated disorders. A comprehensive meta‐analysis assessing the prevalence or risk of vitiligo in AD patients is lacking. Objective To compare the prevalence and assess the risk of vitiligo in patients with AD by performing a meta‐analysis of observational studies. Methods PubMed, Scopus, and Cochrane databases were systematically searched until August 25, 2019, following the PRISMA guidelines. Published English‐language articles including case‐control, cross‐sectional, or cohort studies that reported either odds or risk of vitiligo in AD patients were included. Full‐text review and study assessment were performed by the two authors independently. Random‐effects meta‐analysis model was used to calculate the odds ratio (OR) and risk ratio (RR) with the corresponding 95% confidence interval (CI). The risk of bias was assessed using the Newcastle‐Ottawa Scale. Results Seven studies with a total of 1 540 688 unique AD patients were included. The random‐effects meta‐analysis of case‐control and cross‐sectional studies showed a significant association of AD with vitiligo (OR, 3.21; 95% CI, 1.90‐5.43). Subgroup analyses also showed a significant association for both adult AD (OR, 4.46; 95% CI, 1.65‐12.07) and childhood AD (OR, 2.83; 95% CI, 1.53‐5.25). Pooling of the results of 2 cohort studies showed an increased risk of vitiligo in patients with AD (RR, 1.64; 95% CI, 1.27‐2.13). Conclusions Results from this study support an association of AD with vitiligo. Exploration of possible mechanisms responsible for this association could be important to develop proper treatment approaches for the affected patients.

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Section: Discussionmentioning

confidence: 56%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association of atopic dermatitis with vitiligo: A systematic review and meta‐analysis

Acharya

Mathur

2019

J of Cosmetic Dermatology

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Risk of Inflammatory Bowel Disease in Patients With Atopic Dermatitis

Chiesa Fuxench,

Wan,

Wang

et al. 2023

JAMA Dermatol

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ImportanceData on the association between atopic dermatitis (AD) and inflammatory bowel disease (IBD) are inconsistent. Few studies have examined the association of AD or AD severity with risk of ulcerative colitis (UC) and Crohn disease (CD) separately.ObjectivesTo examine the risk of new-onset IBD, UC, and CD in children and adults with AD.Design, Setting, and ParticipantsThis population-based cohort study assessed patients with AD matched with up to 5 controls on age, practice, and index date. Treatment exposure was used as a proxy for AD severity. Data were retrieved from The Health Improvement Network, a UK electronic medical record database, for January 1, 1994, to February 28, 2015. Data analysis was performed from January 8, 2020, to June 30, 2023.Main Outcomes and MeasuresOutcomes of interest were incident IBD, UC, and CD. Logistic regression was used to examine the risk for each outcome in children and adults with AD compared with controls.ResultsA total of 1 809 029 pediatric controls were matched to 409 431 children with AD (93.2% mild, 5.5% moderate, and 1.3% severe). The pediatric cohort ranged in median age from 4 to 5 years (overall range, 1-10 years), was predominantly male (936 750 [51.8%] controls, 196 996 [51.6%] with mild AD, 11 379 [50.7%] with moderate AD, and 2985 [56.1%] with severe AD), and with similar socioeconomic status. A total of 2 678 888 adult controls were matched to 625 083 adults with AD (65.7% mild, 31.4% moderate, and 2.9% severe). The adult cohort ranged in median age from 45 to 50 years (overall range, 30-68 years) and was predominantly female (1 445 589 [54.0%] controls, 256 071 [62.3%] with mild AD, 109 404 [55.8%] with moderate AD, and 10 736 [59.3%] with severe AD). In fully adjusted models, children with AD had a 44% increased risk of IBD (hazard ratio [HR], 1.44; 95% CI, 1.31-1.58) and a 74% increased risk of CD (HR, 1.74; 95% CI, 1.54-1.97), which increased with worsening AD; however, they did not have increased risk of UC (HR, 1.09; 95% CI, 0.94-1.27) except for those with severe AD (HR, 1.65; 95% CI, 1.02-2.67). Adults with AD had a 34% (HR, 1.34; 95% CI, 1.27-1.40) increased risk of IBD, a 36% (HR, 1.36; 95% CI, 1.26-1.47) increased risk of CB, and a 32% (HR, 1.32; 95% CI, 1.24-1.41) increased risk of UC, with risk increasing with worsening AD.Conclusion and RelevanceIn this cohort study, children and adults with AD had an increased risk of IBD, with risk varying by age, AD severity, and IBD subtype. These findings provide new insights into the association between AD and IBD. Clinicians should be aware of these risks, particularly when selecting systemic treatments for AD in patients who may have coincident gastrointestinal symptoms.

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