Comorbidity burden in adult atopic dermatitis: A population‐based study

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease
that has been shown to be associated with allergic comorbidities. However,
studies examining comorbidities in patients with AD are incomplete, which
may contribute to suboptimal care.
Objectives: The objective was to compare the risk of developing different
allergic and nonallergic comorbidities among adult patients with AD to that of
a matched reference cohort in Sweden.
Methods: This was a nationwide population‐based cohort study using
longitudinal data from primary and specialist care registers. AD patients were
identified by confirmed diagnosis in primary or specialist care. A non‐AD
reference cohort was randomly drawn from the general population and
matched 1:1 with the AD patients on age, gender, and geographical region.
The risk of developing the following conditions was evaluated: asthma, food
hypersensitivity, allergic rhinitis, neurological disorders, psychiatric disorders,
infections, immunological & inflammatory disorders, type 1 diabetes (T1D),
type 2 diabetes (T2D), endocrine & metabolic disorders, skeletal disorders,
ocular disorders, cardiovascular diseases, and malignancies.
Results: This study included 107,774 AD patients [mild‐to‐moderate
(n = 92,413) and severe (n = 15,361)] and an equally‐sized reference cohort.
AD patients displayed a higher risk of developing comorbid conditions for all
investigated categories, except for T1D, compared with the reference cohort.
The highest risk compared with the reference cohort was observed for allergic
comorbidities followed by immunological & inflammatory disorders (hazard
ratio: 2.15) and infections (hazard ratio: 2.01). Patients with AD also had
higher risk of developing multiple comorbidities (2 or more). 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: AD patients are at an increased risk of developing many
comorbidities that extend beyond allergic conditions. This study highlights the
need for interdisciplinary follow‐up of comorbidities in the management of
AD patients to reduce overall patient burden.