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Malignancy risk in patients with atopic dermatitis: a population-based cohort study
Joy Wan1, Daniel B Shin2, Maha N Syed2
1Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
The British Journal of Dermatology
|July 7, 2023
Summary
This study found no overall increased cancer risk in children and adults with atopic dermatitis (AD). However, severe AD was linked to a higher risk of lymphoma, and mild AD to nonmelanoma skin cancer.
Area of Science:
- Dermatology and Oncology
- Epidemiology
- Immunodermatology
Background:
- Atopic dermatitis (AD) involves immune dysfunction, potentially impacting cancer development.
- Previous research on AD and cancer yields inconsistent findings, with limited data on pediatric populations or AD severity.
- Understanding the relationship between AD severity, treatment, and malignancy risk is crucial.
Purpose of the Study:
- To investigate the association between atopic dermatitis (AD) and the risk of developing various malignancies in both children and adults.
- To analyze how AD severity, categorized by treatment and specialist referrals, influences specific cancer risks.
- To provide updated epidemiological evidence on AD and cancer risk in a large cohort.
Main Methods:
- A UK-based cohort study utilized electronic health records from 1994-2015.
- Children and adults with AD were matched to controls without AD, with AD severity classified as mild, moderate, or severe.
- Primary outcome was incident malignancy (all types), with secondary outcomes including specific cancers like leukemia, lymphoma, melanoma, and nonmelanoma skin cancer (NMSC).
Main Results:
- In children, overall malignancy risk was similar between AD and control groups; however, severe AD correlated with increased lymphoma risk, and mild AD with increased NMSC risk.
- In adults, overall malignancy risk was not significantly different, but severe AD showed a twofold higher risk for non-cutaneous T-cell lymphoma (non-CTCL).
- AD was associated with a slight increase in overall skin cancer risk and a slight decrease in solid cancer risk, with variations based on specific cancer types and AD severity.
Conclusions:
- Current epidemiological data do not indicate a substantial overall increase in malignancy risk associated with atopic dermatitis (AD).
- Severe AD may be linked to an elevated risk of lymphoma, particularly non-CTCL in adults.
- Further research may clarify the nuanced relationship between AD severity, specific cancer types, and immunological factors.
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