TY - JOUR
T1 - Risk of systemic infections in adults with atopic dermatitis
T2 - A nationwide cohort study
AU - Droitcourt, Catherine
AU - Vittrup, Ida
AU - Kerbrat, Sandrine
AU - Egeberg, Alexander
AU - Thyssen, Jacob P
N1 - Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
PY - 2021/2
Y1 - 2021/2
N2 - BACKGROUND: Atopic dermatitis (AD) has been linked to systemic infections in adulthood, but large-scale studies are few, and potential associations are unclear.OBJECTIVE: To examine whether adults with AD have increased risk of developing systemic infections leading to hospital-based management.METHODS: Nationwide register-based cohort study including all Danish adults from 1995 through 2017. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated by using Cox models.RESULTS: A total of 10,602 adults with AD (median age, 29.8 y; interquartile range, 22.6-44.8) and 106,020 reference individuals were included. The overall incidence rate per 10,000 person-years of systemic infections was 180.6 (95% CI, 172.6-189.0) among adults with AD compared with 120.4 (95% CI, 118.3-122.5) among reference adults. The association between AD and systemic infections was observed for musculoskeletal (adjusted HR [aHR], 1.81; 95% CI, 1.42-2.31), heart (aHR, 1.75; 95% CI, 1.21-2.53), and upper (aHR, 1.42; 95% CI, 1.15-1.73) and lower respiratory tract infections (aHR, 1.21; 95% CI, 1.10-1.33). The risk of sepsis (aHR, 1.19; 95% CI, 1.01-1.44) and skin infections (aHR, 2.30; 95% CI, 2.01-2.62) was also increased.LIMITATIONS: The findings cannot be generalized to adults with milder AD seen outside the hospital system.CONCLUSION: We found an increased risk of systemic infections among adults with hospital managed AD.
AB - BACKGROUND: Atopic dermatitis (AD) has been linked to systemic infections in adulthood, but large-scale studies are few, and potential associations are unclear.OBJECTIVE: To examine whether adults with AD have increased risk of developing systemic infections leading to hospital-based management.METHODS: Nationwide register-based cohort study including all Danish adults from 1995 through 2017. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated by using Cox models.RESULTS: A total of 10,602 adults with AD (median age, 29.8 y; interquartile range, 22.6-44.8) and 106,020 reference individuals were included. The overall incidence rate per 10,000 person-years of systemic infections was 180.6 (95% CI, 172.6-189.0) among adults with AD compared with 120.4 (95% CI, 118.3-122.5) among reference adults. The association between AD and systemic infections was observed for musculoskeletal (adjusted HR [aHR], 1.81; 95% CI, 1.42-2.31), heart (aHR, 1.75; 95% CI, 1.21-2.53), and upper (aHR, 1.42; 95% CI, 1.15-1.73) and lower respiratory tract infections (aHR, 1.21; 95% CI, 1.10-1.33). The risk of sepsis (aHR, 1.19; 95% CI, 1.01-1.44) and skin infections (aHR, 2.30; 95% CI, 2.01-2.62) was also increased.LIMITATIONS: The findings cannot be generalized to adults with milder AD seen outside the hospital system.CONCLUSION: We found an increased risk of systemic infections among adults with hospital managed AD.
KW - adulthood
KW - atopic dermatitis
KW - epidemiology
KW - risk
KW - systemic infections
UR - http://www.scopus.com/inward/record.url?scp=85097364430&partnerID=8YFLogxK
U2 - 10.1016/j.jaad.2020.07.111
DO - 10.1016/j.jaad.2020.07.111
M3 - Journal article
C2 - 32750384
VL - 84
SP - 290
EP - 299
JO - American Academy of Dermatology. Journal
JF - American Academy of Dermatology. Journal
SN - 0190-9622
IS - 2
ER -