Bone mineral density in patients with atopic dermatitis

Area of Science:

• Endocrinology
• Dermatology
• Osteology

Background:

• Chronic atopic dermatitis affects skin barrier function and may involve systemic inflammation.
• Glucocorticoids (GCs) are commonly used to manage atopic dermatitis, but their long-term systemic effects on bone health are a concern.

Purpose of the Study:

• To assess the systemic effects of glucocorticoids (GCs) on bone mineral density (BMD) in adult patients with chronic atopic dermatitis.
• To investigate potential correlations between BMD and factors like skin barrier function, disease duration, and GC usage.

Main Methods:

• Bone mineral density (BMD) was measured in 29 adult patients with chronic atopic dermatitis using dual-energy X-ray absorptiometry (DEXA) at the lumbar spine and femoral neck.
• Broad-spectrum ultrasound attenuation (BUA) was used to measure BMD in the calcaneus.
• Statistical analyses were performed to correlate BMD with risk factors and disease severity.

Main Results:

• Patients with atopic dermatitis did not show significantly different BMD compared to healthy controls overall.
• No significant correlation was found between BMD and skin barrier function, disease duration, or use of oral/potent topical GCs.
• However, patients with severe disease requiring topical GCs more potent than hydrocortisone (HC) exhibited lower lumbar BMD compared to those not using such preparations (P = 0.026).

Conclusions:

• While general BMD is unaffected in atopic dermatitis patients, severe cases requiring potent topical GCs may experience reduced lumbar BMD.
• This finding suggests a potential long-term systemic effect of GCs on bone density in specific patient subgroups.
• Further research is warranted to elucidate the precise mechanisms and clinical implications.