Major comorbidities greater in adults with atopic dermatitis
There is a significant and disease severity‒dependent increased risk of developing conjunctivitis, keratitis and keratoconus in adults with atopic dermatitis (AD) compared with the general population, according to a recent study.
Researchers linked all Danish individuals aged ≥18 years in nationwide registries to investigate the prevalence and risk of selected ocular comorbidities in adult patients with AD. Cox regression was used to estimated adjusted hazard ratios (HRs).
In total, there were 5,766 and 4,272 adults who were classified as having mild and severe AD, respectively. At least one prescription of anti-inflammatory ocular agents was claimed in 12.0 and 18.9 percent of patients with mild and severe AD, respectively.
Adjusted analysis revealed that the HR of conjunctivitis for mild AD was 1.48 (95 percent CI, 1.15 to 1.90) and 1.95 (1.51 to 2.51) for severe AD. The HR of keratitis was 1.66 (1.15 to 2.40) and 3.17 (2.31 to 4.35) for mild and severe AD, respectively. The HR for keratoconus in adults with severe AD was 10.01 (5.02 to 19.96). There was an association between AD and “cataract only” among individuals aged <50 years.
One limitation of this study is the failure to establish causality due to its observational design.
In a separate study, the same authors noted that the risk for major comorbidities was significantly elevated in adults with AD compared with controls. Furthermore, the risk difference was predominantly found in patients with severe disease and among smokers. [J Am Acad Dermatol 2017;76:1088-1092.e1]
Ocular comorbidities are common in AD as a result of the disease itself or the use of medication, according to researchers.