Real-world comorbidities of atopic dermatitis in the US adult ambulatory population

Youkyung S Roh; Amy H Huang; Nishadh Sutaria; Una Choi; Shannon Wongvibulsin; Justin Choi; Zachary A Bordeaux; Varsha Parthasarathy; Junwen Deng; Deepa P Patel; Joseph K Canner; Anna L Grossberg; Shawn G Kwatra

doi:10.1016/j.jaad.2021.11.014

Real-world comorbidities of atopic dermatitis in the US adult ambulatory population

J Am Acad Dermatol. 2022 Apr;86(4):835-845. doi: 10.1016/j.jaad.2021.11.014. Epub 2021 Nov 18.

Affiliations

¹ Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
² Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
³ Department of Dermatology, Albert Einstein College of Medicine, Bronx, New York.
⁴ Johns Hopkins Surgery Center for Outcomes Research, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
⁵ Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland. Electronic address: skwatra1@jhmi.edu.

PMID: 34800600
DOI: 10.1016/j.jaad.2021.11.014

Abstract

Background: Atopic dermatitis (AD) is a pruritic, inflammatory skin disease associated with various comorbidities. However, comprehensive analyses of real-world comorbidities in adult patients with AD are limited.

Objective: To characterize the real-world comorbidities associated with adult AD in an ambulatory population.

Methods: We queried the MarketScan Commercial Claims and Encounters database from January 1, 2017 to December 31, 2017. Multivariable logistic regressions were performed to compare comorbidities in adult patients with AD versus age- and sex-matched controls.

Results: A total of 39,779 patients with AD and 353,743 controls were identified. Increased odds of psychiatric conditions, including anxiety (odds ratio [OR] 1.44) and mood disorders (OR 1.31), were observed in patients with AD. Patients with AD had higher likelihoods of autoimmune diseases, including vitiligo (OR 4.44) and alopecia areata (OR 6.01). Adult AD was also associated with infections, including impetigo (OR 9.72), methicillin-resistant Staphylococcus aureus (OR 3.92), and cellulitis (OR 2.52). Patients with AD were more likely to have systemic conditions, including lymphoid/hematopoietic malignancy (OR 1.91), atherosclerosis (OR 1.69), and metabolic syndrome (OR 1.47). For all the above, P < .001.

Limitations: Retrospective analysis of health care claims data.

Conclusion: Adult AD is associated with various psychiatric and systemic comorbidities, emphasizing the systemic nature of AD and the need for the collaborative management of these patients.

Keywords: MarketScan; atopic dermatitis; comorbidities; eczema; epidemiology; itch; pruritus.

MeSH terms

Adult
Comorbidity
Dermatitis, Atopic* / epidemiology
Humans
Methicillin-Resistant Staphylococcus aureus*
Retrospective Studies