Infecciones aumentadas en pacientes adultos con DA.

Published in Dermatology

Journal Scan / Research · August 22, 2020

Risk of Systemic Infections in Adults With Atopic Dermatitis

Journal of the American Academy of Dermatology

TAKE-HOME MESSAGE

• Using the Danish national medical registry, the rates of systemic infections in hospitalized patients with ICD-10 codes for atopic dermatitis were compared with those in patients without atopic dermatitis. All systemic infections had higher incidence rates compared with non-atopics. The highest risks were for skin, musculoskeletal, and cardiac infections.

• In this large, nation-wide registry study, patients with a diagnosis of atopic dermatitis had a higher risk of systemic infections, particularly involving the skin, heart, and musculoskeletal systems. This may be due to superinfection of active skin lesions or defects in immune regulation. Clinicians managing patients with atopic dermatitis should be aware of these potential associations.

– Margaret Hammond, MD

Abstract

BACKGROUND

Atopic dermatitis (AD) has been linked to systemic infections in adulthood, but 65 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 1.42-76 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.

Journal of the American Academy of Dermatology

Risk of Systemic Infections in Adults With Atopic Dermatitis: A Nationwide Cohort Study

J Am Acad Dermatol 2020 Aug 01;[EPub Ahead of Print], C Droitcourt, I Vittrup, S Kerbrat, A Egeberg, JP Thyssen