Comorbidities of Eczema Are Numerous

TOPLINE:
Individuals with eczema have elevated risk for more than 60 medical conditions, both other atopic and allergic conditions, and unrelated conditions.
METHODOLOGY: 
Investigators conducted a comparative cohort study using UK Clinical Practice Research Datalink Aurum primary care records for 1997-2023.
Analyses compared up to 3.6 million people of any age with eczema with 16.8 million without eczema matched for age, sex, and general practice.
The main outcomes were risks for 71 other health conditions.
TAKEAWAY:
Relative to unaffected peers, individuals with eczema had higher risk for various atopic and allergic conditions, especially food allergy (adjusted hazard ratio, 4.02), allergic conjunctivitis (2.02), allergic rhinitis (1.93), and asthma (1.87).
They also had an elevated risk for other conditions, particularly Hodgkin lymphoma (adjusted hazard ratio, 1.85), molluscum contagiosum (1.81) and other skin infections, alopecia areata (1.77), Crohn’s disease (1.62), urticaria (1.58), coeliac disease (1.42), ulcerative colitis (1.40), autoimmune liver disease (1.32), and irritable bowel syndrome (1.31).
Risks for conditions that were strongly associated with eczema generally rose with eczema severity; for example, the risk for food allergy increased going from mild eczema (adjusted hazard ratio, 3.66) to moderate eczema (4.19) to severe eczema (5.72).
IN PRACTICE:
“Whether associations are causal, implying effective diagnosis and treatment for eczema could prevent the development of these comorbidities, is not possible to determine from this study alone,” the authors wrote. “However, irrespective of causality, the increased risk found for being diagnosed with conditions subsequent to eczema emphasises the importance of a multidisciplinary approach to care for these individuals,” they concluded.
SOURCE:
The study was led by Julian Matthewman, MD, PhD, MSc, London School of Hygiene & Tropical Medicine, London, UK, and was published online in Nature Communications.
LIMITATIONS:
Limitations included missed diagnoses made outside primary care, possible residual and unmeasured confounding, and the definitions used for eczema severities.
DISCLOSURES:
The study was funded by fellowship awards to investigators from the Wellcome Trust and the National Institute for Health and Care Research. One author disclosed being a co-investigator in a consortium with industry and academic partners.
 
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