Atopic dermatitis comes with added infection risk.
Adults with atopic dermatitis (AD) are at increased risk for contracting extracutaneous infectious diseases, with greater risk in those having an additional atopic disease, according to a recent analysis of data from the 2012 National Health Interview Survey.
"Systemic immune dysregulation occurring in AD may increase the risk of extracutaneous infection, although the exact role remains unclear," observed Jonathon Silverberg, MD, PhD, Departments of Dermatology, Preventative Medicine and Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL and co-author Mark Strom, BS, Northwestern University. "In the present study, we sought to determine whether adult AD is associated with various etiologies of extracutaneous infection."
Their findings were reported on-line October 17 in the British Journal of Dermatology. Association Between Atopic Dermatitis and Extracutaneous Infections in US Adults
Silverberg and colleagues had previously determined increased risk of extracutaneous infection in childhood AD, and the present study utilized data from the 2012 National Health Interview Survey (NHIS) to ascertain risk with adult AD. The nationally representative, cross-sectional household interview survey of adults 18 years of age or older documented health conditions and healthcare for the preceding 12 months.
A range of infectious conditions were contained in the survey, including influenza/pneumonia, strep throat, sinus infection, gastroenteritis, chickenpox, hepatitis, as well as a general category of "other" infectious diseases/immune problems. Reported infections were analyzed between adults having AD with and without additional atopic disease (2,488) and those without AD (32,100).
Silverberg and Strom reported that adults with AD compared to no AD had increased risk for each infectious condition other than hepatitis. The increased odds ratio (OR) in those with AD compared to no AD was most strongly associated with having four or more infections (2.78, with 95% confidence interval 1.82-4.24). Having AD with another atopic illness was associated with even higher risk for two, three and four or more infections compared with AD alone.
The investigators found the increased risk for influenza/pneumonia in adults with AD of particular interest, as a previous study had determined that this group has higher rates of vaccination against these illnesses. Among the limitations of the study methods, which includes patient report rather than physician diagnosis, is that the investigators were unable to determine use of immunosuppressive medications, which could have increased risk unrelated to the underlying disease.