Atopic eczema associated with excessive scarring across ethnic groups
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Patients with keloids and hypertrophic scarring were at a higher risk of developing atopic eczema, in addition to other comorbidities, across three major ethnic groups, according to a study.
Keloids and hypertrophic scars are chronic disfiguring manifestations of excessive cutaneous wound healing and are often accompanied by adverse symptoms. In addition to the lack of effective treatment for this condition, many patients are at risk for greater health concerns.
“Awareness of comorbidities of excessive skin scarring may help with early identification, and even prevention, of internal problems associated with visible skin scarring,” Tanya J. Shaw, PhD, of King’s College London in England, told Healio.
In this multicenter, cross-sectional, population-based cohort study, researchers evaluated the comorbidities of excessive scarring with comparisons across ethnic groups in European individuals aged 40 to 69 years from the UK Biobank. The study compared 972 patients (mean age, 63 years; 65.1% women; 85.3% white) with 229,106 controls (mean age, 64 years; 54.6% women; 94.9% white).
The researchers further assessed whether disease associations varied by ethnicity by performing fully adjusted logistic regressions for white, Black and Asian individuals, which were the three largest ethnic groups represented. The researchers also used a phenome-wide association study (PheWAS) to identify novel comorbidities.
Results showed that excessive scarring is associated with atopic eczema, hypertension, vitamin D deficiency and uterine leiomyoma, with evidence that associations varied across ethnicities.
Black individuals experienced the most scarring at 2.4% compared with 1.1% in Asian individuals and 0.4% in white individuals.
In adjusted analyses, Black participants were associated with hypertension (adjusted OR = 2.05; 95% CI, 1.13-3.72), and there was a borderline significant association with uterine leiomyoma in Black women (aOR = 1.93; 95% CI, 1-3.71). Asian participants had an association with vitamin D deficiency (aOR = 2.24; 95% CI, 1.26-3.97).
The association between excessive scarring and atopic eczema was the only comorbidity that spanned ethnic groups. This association was highly significant in white participants (OR = 1.68; 95% CI, 1.34-2.12) and nominally significant in Asian participants (OR = 2.17; 95% CI, 1.01-4.67). While this association was not statistically significant in Black participants (OR = 1.89; 95% CI, 0.83-4.28), the researchers said that the association exhibited a similar trend.
Additionally, the researchers said that PheWAS identified 110 diseases enriched in participants with excessive scarring. Outside of dermatological diseases, these included musculoskeletal disease and pain symptoms.
According to the researchers, there is a need for further investigation into these associations, especially across additional ethnic groups.
“The co-occurrence of excessive scarring with atopic eczema, hypertension, musculoskeletal diseases and pain hints that there may be common mechanisms and maybe even causal biological relationships that warrant further investigation,” Shaw told Healio.