High Rate of Alcohol Use Disorder in Atopic Dermatitis

Physicians should ask patients with eczema about their alcohol usage.

In a study published in the British Journal of Dermatology, researchers found that about a third of patients with eczema had alcohol use disorder; about as prevalent as in patients with psoriasis.

An association is known to exist between psoriasis and heavy alcohol consumption. To examine whether a high prevalence of alcohol use disorder (AUD) also exists in people with other inflammatory skin diseases, an observational, cross-sectional study in a single hospital outpatient department was conducted.

A total of 609 patients were divided into 2 groups. The first group comprised patients with inflammatory skin diseases, such as psoriasis, eczema, and cutaneous lupus (n=428); the second group included those with noninflammatory skin conditions, mainly skin lesions (n=181). The objective of the study was to examine the prevalence of heavy drinking in patients with inflammatory skin diseases using the Alcohol Use Disorders Identification Test (AUDIT).

Based on AUDIT findings, the observed prevalence of AUD was 30.6% in patients with psoriasis, 33.3% in those with eczema, 12.3% in patients with cutaneous lupus, 21.8% in patients with other inflammatory skin diseases, and 14.3% in those with noninflammatory skin conditions. Odds ratios (ORs) for AUD in the inflammatory group vs the noninflammatory group were as follows: psoriasis (OR, 1.65; 95% CI, .86-3.17); eczema (OR, 2.00; 95% CI, 1.03-3.85); cutaneous lupus (OR, 1.03; 95% CI <.39-2.71); other inflammatory skin conditions (OR, 1.32; 95% CI, .68-2.56). The ORs were reduced if the values were also adjusted for Dermatology Life Quality Index (DLQI), with the prevalence of DLQI ≥11 reported as 31.1% for psoriasis, 43.7% for eczema, 17.5% for cutaneous lupus, 17.2% for other inflammatory skin diseases, and 2.8% for noninflammatory skin conditions.

The investigators concluded that an association exists between AUD and eczema that is similar to that of AUD and psoriasis, and rates of AUD are higher in these patients than in patients with noninflammatory skin conditions. Increased efforts are needed in dermatology clinics to identify patients with heavy alcohol consumption to both help ensure safe drug prescribing and allow support in achieving safe levels of alcohol use.

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Al-Jefri K, Newbury-Birch D, Muirhead CR, et al. High prevalence of alcohol use disorders in patients with inflammatory skin diseases [published online March 27, 2017]. Br J Dermatol. doi:10.1111/bjd.15497