Real-world comorbidities of atopic dermatitis in the pediatric ambulatory population in the United States - 13/04/21

Doi : 10.1016/j.jaad.2021.03.016

Amy H. Huang, MD, MPH ^a,^b, Youkyung Sophie Roh, BA ^a, Nishadh Sutaria, BS ^a, Justin Choi, BA ^a, Kyle A. Williams, BS ^a, Joseph K. Canner, MHS ^c, Anna L. Grossberg, MD ^a, Shawn G. Kwatra, MD ^a,^b,^⁎
^a Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland
^b Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
^c Johns Hopkins Surgery Center for Outcomes Research, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland

^∗Correspondence to: Shawn G. Kwatra, MD, Cancer Research Building II, Johns Hopkins University School of Medicine, Suite 206, 1550 Orleans Street, Baltimore, MD 21231.Cancer Research Building IIJohns Hopkins University School of MedicineSuite 206, 1550 Orleans StreetBaltimoreMD21231

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Tuesday 13 April 2021
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Abstract

Background

Increasing evidence has suggested the systemic nature of atopic dermatitis (AD), a common inflammatory skin condition in children. However, comprehensive analyses of real-world comorbidities in pediatric AD are limited.

Objective

To characterize comorbidity burden in patients with AD aged <18 years old.

Methods

The MarketScan commercial claims database was queried from January 1, 2017, to December 31, 2017. Age- and sex-matched analyses were used to compare patients with AD with general population controls.

Results

A total of 86,969 pediatric patients with AD and 116,564 matched controls were identified. Increased anxiety (odds ratio [OR], 1.20) and attention-deficit hyperactivity disorder (OR, 1.11) were noted in patients with AD. In addition to dermatologic/allergic diseases, AD was also associated with infections, including methicillin-resistant Staphylococcus aureus (OR, 3.76), and autoimmune conditions, including vitiligo (OR, 2.98) and alopecia areata (OR, 4.32). Pediatric patients with AD had higher likelihoods of lymphoid/hematologic malignancies (OR, 1.94), ocular disorders (OR, 1.37-2.02), metabolic syndrome (OR, 1.61), and obesity (OR, 1.81). For all the ORs mentioned above, P was <.001.

Limitations

Retrospective analysis of health care claims data.

Conclusions

AD in pediatric patients was associated with a wide range of psychologic and systemic comorbidities. Increased awareness can help minimize its negative effects on the quality of life and prevent long-term health consequences in young patients with AD.

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Key words : atopic dermatitis, comorbidities, eczema, MarketScan, pediatric

Abbreviations used : AD, CI, ICD-10-CM, MRSA, OR

Plan

Introduction

Methods

Results

Mental health conditions

Infectious diseases

Autoimmune conditions

Neurologic/ocular diseases

Dermatologic diseases

Allergic conditions

Oncologic diseases

Systemic comorbidities

Other

Discussion

Conclusions

	Funding sources: Dr Kwatra is supported by grant funding from Pfizer, Inc, the Skin of Color Society and a Dermatology Foundation Medical Dermatology Career Development Award.
	IRB approval status: Institutional review board approval for the study was obtained from the Johns Hopkins University School of Medicine.
	Reprints not available from the authors.