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Atopic Dermatitis Severity and Risk for Psoriasis: A Nationwide Population-Based Study.
Hyun Ji Lee1, Yong Jun Hong2, Kyung Do Han3
1Department of Dermatology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea, o0or5r5r@gmail.com.
Dermatology (Basel, Switzerland)
|January 16, 2024
Summary
Individuals with atopic dermatitis (AD) face a significantly higher risk of developing psoriasis. The severity of AD directly correlates with an increased risk for psoriasis, suggesting shared underlying mechanisms.
Area of Science:
- Dermatology
- Immunology
- Genetics
Background:
- The Th17/IL-23 pathway is increasingly recognized for its role in inflammatory skin conditions.
- Emerging research is clarifying the connection between atopic dermatitis (AD) and psoriasis.
Purpose of the Study:
- To determine if atopic dermatitis (AD) and its severity influence the risk of developing psoriasis.
- Investigate the association between AD severity and subsequent psoriasis diagnosis.
Main Methods:
- Retrospective population-based study utilizing the 2009 National Health Insurance Services-Health Screening Cohort in Korea.
- Inclusion of 3,957,922 adult subjects observed from 2009 to 2018.
- Primary endpoint: new diagnosis of psoriasis.
Main Results:
- Moderate-to-severe AD was associated with the highest hazard ratio (HR) for psoriasis (HR = 2.50; 95% CI, 2.40-2.61).
- Mild AD also showed an increased risk for psoriasis (HR = 2.31; 95% CI: 2.19-2.44) compared to individuals without AD.
- A clear dose-response relationship was observed between AD severity and psoriasis risk over a median follow-up of 8.11 years.
Conclusions:
- Severe atopic dermatitis (AD) increases the risk of psoriasis.
- Psoriasis risk escalates with increasing AD severity, indicating potential shared inflammatory, immune, and genetic pathways.
- Limitations include the challenge of standardizing AD diagnosis in claims databases and potential for misdiagnosis.
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