Atopic Dermatitis Comorbidities Clinical Guidelines and Resources | Figure 1
Atopic Dermatitis Comorbidities Clinical Guidelines and Resources
Figure 1, 2 ,3
Clear links identified between atopic dermatitis, asthma, and allergic conditions
Patients are more likely to have autoimmune issues; including alopecia areata and chronic urticaria
Patients are more likely to have psychosocial disorders; but links not yet established
Summary
The American Academy of Dermatology (AAD) released updated guidelines in 2022 on comorbidities associated with atopic dermatitis in adults. Here’s a brief summary of some key recommendations for dermatologists and other healthcare professionals coming out of the guidelines.
First, there are now clear links between atopic dermatitis, asthma, and allergic conditions. A quarter of all atopic dermatitis patients have asthma, and adults with atopic dermatitis are three times more likely to have asthma than the general population. There also appears to be a link between the severity of atopic dermatitis and asthma. The more severe atopic dermatitis is, the more likely the patient will have asthma as well.
Atopic Dermatitis Comorbidities Clinical Guidelines and Resources
Immunoglobulin-E-mediated food allergies also now have a clear connection with atopic dermatitis, and just like with asthma, the more severe atopic dermatitis is in a patient, the more likely they are to have food allergies.
A second take away from the guidelines is there’s a link between atopic dermatitis and autoimmune conditions. People with atopic dermatitis are 26 times more likely to develop alopecia areata than people without atopic dermatitis. To date, there is no approved treatment in the United States for alopecia areata.
Similarly, chronic urticaria is also strongly associated with atopic dermatitis, with atopic dermatitis patients being 10 times more likely to develop chronic urticaria than people without atopic dermatitis. While treatments exist for chronic urticaria, their effectiveness in patients who also have atopic dermatitis appears to be more limited.
A third take away from the guidelines is patients with atopic dermatitis are more likely to have psychosocial disorders. Atopic dermatitis patients are around one and a half times more likely to report anxiety symptoms, and twice as likely to report depression than people without atopic dermatitis. That said, the reasons why atopic dermatitis patients are more likely to experience these mental health disorders have yet to be established. One theory suggests the symptoms of atopic dermatitis, such as itch, and poor sleep, cause a psychosocial burden, although further research is needed.
A fourth takeaway from the guidelines is there is a small association between atopic dermatitis and cardiovascular conditions like myocardial infarction and hypertension. However, the association between these conditions is weak. Further research is needed to determine if these associations have any clinical implications.
Full Guidelines
Read the full guidelines on atopic dermatitis comorbidities from AAD: Awareness of Comorbidities Associated with Atopic Dermatitis in Adults
Statement Wording and Certainty Evidence
Atopic Dermatitis Patient Cases
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Atopic dermatitis in a 8 months old boy. He also had this on his legs and back…
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Continuing Medical Education
Free CME Activity: Learn to identify the clinical presentation of vitiligo, a chronic autoimmune disorder of pigmentation associated with atopic dermatitis. You will also better understand the role of decreased alpha-melanocyte-stimulating hormone (alpha-MSH) in the pathophysiology of vitiligo and importance of alpha-MSH in modulating melanogenesis and inflammation. Start activity >
Related Research
Atopic Dermatitis and Risk of Autoimmune Diseases: A Systematic Review and Meta-Analysis | PubMed
Atopic Dermatitis—Beyond the Skin | PubMed
Atopic Dermatitis: An Expanding Therapeutic Pipeline for a Complex Disease | PubMed