Atopic Dermatitis Shows Higher Risk for All-Cause Mortality

All-cause and cause-specific mortality risk associated with infectious, respiratory, gastrointestinal, and neoplasm/oncologic diseases was higher in patients with atopic dermatitis (AD).

Patients with atopic dermatitis (AD) have an increased risk for all-cause and cause-specific mortality associated with infectious, respiratory, gastrointestinal, and neoplasm/oncologic diseases compared with control individuals, as reported in study data published in the Journal of the European Academy of Dermatology and Venereology.

Researchers assessed the all-cause and cause-specific mortality risk in patients with AD with use of the National Health Insurance Service database and National Death Registry of Korea.

Participants were from all age groups and had 3 or more inpatient or outpatient visits for AD as a principal diagnosis from 2003 through 2019. The patients were matched 1:1 with control individuals without AD-related visits according to age, sex, insurance type, and income level. Multivariable Cox proportional hazard analysis was used to estimate all-cause and cause-specific mortality risks.

A total of 254,644 patients and 254,644 control individuals were included (52% female and 54% aged older than 10 years in each group). Patients with AD were more likely to have higher income levels and less likely to be obese or current smokers or to use alcohol vs control individuals, it was noted.

…immunosuppressant and barrier disruption could contribute to microbial susceptibility and bacterial colonization inducing penetration of pathogens and systemic infection.

Patients with AD had a higher mortality risk compared with control individuals in the total cohort (adjusted hazard ratio [aHR], 1.05; 95% CI, 1.01-1.09) and adult population (HR, 1.14; 95% CI, 1.09-1.20). The risk for mortality was greater in patients with infectious (adult: aHR, 1.49; 95% CI, 1.08-2.04), respiratory (total: aHR, 1.22; 95% CI, 1.06-1.40; adult: aHR, 1.24; 95% CI, 1.05-1.46), and gastrointestinal (adult: aHR, 1.55; 95% CI, 1.18-2.04) diseases. The mortality risk was also greater in patients who had neoplasm/oncologic diseases (adult: aHR, 1.10; 95% CI, 1.00-1.20), particularly those with NK/T cell lymphoma (aHR, 2.83; 95% CI, 1.12-7.19).

Study limitations include the retrospective design, single ethnicity, and misclassification bias, and reduced access to medical care may have caused selection bias.

“Our infectious disease-related findings are similar to those of previous studies, and immunosuppressant and barrier disruption could contribute to microbial susceptibility and bacterial colonization inducing penetration of pathogens and systemic infection,” stated the study authors.

References:

Jung S-W, Lee S. All-cause and cause-specific mortality risk associated with atopic dermatitis: a Korean nationwide population-based study. J Eur Acad Dermatol Venereol. Published online December 4, 2022. doi:10.1111/jdv.18803