Risk of systemic infections in adults with atopic dermatitis: a nationwide cohort study

  • Catherine Droitcourt
    Correspondence
    Corresponding author: Dr Catherine Droitcourt, Department of Dermatology, Pontchaillou Hospital, 2 rue Henri le Guilloux 35000 Rennes, France, Tel: + 33 2 99 28 43 49, Fax: + 33 2 99 28 41 00, Mailto:
    Affiliations
    Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

    Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, Hellerup, Denmark

    Department of Dermatology, CHU Rennes, F35000 Rennes, France

    University of Rennes, EA 7449 REPERES “Pharmacoepidemiology and Health Services Research”, F35000 Rennes, France
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  • Ida Vittrup
    Affiliations
    Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

    Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, Hellerup, Denmark
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  • Sandrine Kerbrat
    Affiliations
    University of Rennes, EA 7449 REPERES “Pharmacoepidemiology and Health Services Research”, F35000 Rennes, France
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  • Alexander Egeberg
    Affiliations
    Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

    Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, Hellerup, Denmark
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  • Jacob P. Thyssen
    Affiliations
    Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

    Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, Hellerup, Denmark
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Published:August 01, 2020DOI:https://doi.org/10.1016/j.jaad.2020.07.111
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      Abstract

      Background

      Atopic dermatitis (AD) has been linked to systemic infections in adulthood, but large-scale studies are few and potential associations 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 (HR) with 95% confidence intervals (CI) were estimated using Cox models.

      Results

      10,602 adults with AD (median age 29.8 years, 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 AD adults 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), 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.

      Keywords

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