Atopic dermatitis may be linked to inflammatory bowel disease
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Key takeaways:
- An association between more severe atopic dermatitis and inflammatory bowel disease has been found.
- These findings suggest a multidisciplinary approach is necessary.
An association between moderate to severe atopic dermatitis and inflammatory bowel disease suggests a multidisciplinary approach to AD may be necessary, according to a study.
“There is growing evidence that systemic immune dysregulation plays a significant role in AD,” Hadass Rom, MD, of the department of dermatology at the Chaim Sheba Medical Center, and colleagues, wrote. “Multiple susceptibility loci for AD are associated with immune regulation and autoimmunity, and some are shared with other immune-mediated diseases, including [inflammatory bowel disease (IBD)].”
Researchers conducted a retrospective observational cross-sectional study comparing the medical records of 364 patients with AD with those of 725 age- and gender-matched control patients without AD at one dermatology clinic.
Nine (2.47%) of the patients with AD also had IBD, with three having ulcerative colitis and six having Crohn’s disease. Of the control patients, seven (0.97%) had IBD, with four having ulcerative colitis and three having Crohn’s disease.
The odds ratio for IBD diagnosis was significant when using multivariable logistic regression adjusting for age, gender and smoking status (adjusted OR = 3.89; 95% CI, 1.28-11.85).
Mild AD was not associated with IBD; however, the researchers found moderate to severe AD to be associated (aOR = 4.45; 95% CI, 1.43-13.9).The researchers further found that older age was also linked to having IBD (P = .0172).
“Our study has several clinical implications. A holistic multidisciplinary approach is suggested in patients with AD to address disease impact and comorbidities. Our findings, taken together with the prior evidence, suggest that IBD prevalence is increased in patients with AD, particularly in the moderate to severe forms,” the authors wrote. “Clinicians should be conscious of this association and encourage a thorough workup of prolonged gastrointestinal complaints such as diarrhea, rectal bleeding and abdominal pain. In patients who have both AD and IBD, a multidisciplinary treatment approach is recommended.”
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