Lebwohl Benjamin, Söderling Jonas, Roelstraete Bjorn, Lebwohl Mark G, Green Peter H R, Ludvigsson Jonas F
Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York, New York; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
Department Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
J Am Acad Dermatol. 2021 Dec;85(6):1456-1464. doi: 10.1016/j.jaad.2020.10.079. Epub 2020 Nov 1.
Although dermatitis herpetiformis is closely associated with celiac disease (CD), data on the relationship between CD and other dermatologic disorders have been mixed. We aimed to quantify the risk of skin disorders in patients after CD diagnosis in a population-based setting.
Using data from all 28 pathology departments in Sweden from 1969 to 2016, we identified patients with CD. Each patient was matched by age, sex, calendar year, and geographic region to up to 5 population control individuals. We calculated the risk of any skin disease and specific skin diseases using Cox proportional hazards.
We identified 43,300 patients with CD and 198,532 matched control individuals. After a median follow-up time of 11.4 years, the incidences of skin disease in patients with CD and control individuals were 22.6 and 14.8 per 1000 person-years, respectively (hazard ratio [HR], 1.55; 95% confidence interval [CI], 1.51-1.58). Increased risks were present for eczema (HR, 1.67; 95% CI, 1.56-1.79), psoriasis (HR, 1.55; 95% CI, 1.43-1.68), urticaria (HR, 1.52; 95% CI, 1.42-1.64), vitiligo (HR, 1.90; 95% CI, 1.52-2.39), acne (HR, 1.39; 95% CI, 1.29-1.50), and alopecia areata (HR, 1.78; 95% CI, 1.43-2.20).
Compared to the general population, patients with CD are at increased risk of multiple common skin disorders, a risk that persists in the long term.
尽管疱疹样皮炎与乳糜泻(CD)密切相关,但关于CD与其他皮肤病之间关系的数据却参差不齐。我们旨在在基于人群的环境中量化CD诊断后患者出现皮肤疾病的风险。
利用瑞典所有28个病理科1969年至2016年的数据,我们确定了患有CD的患者。每位患者按年龄、性别、日历年和地理区域与多达5名人群对照个体进行匹配。我们使用Cox比例风险模型计算了任何皮肤病和特定皮肤病的风险。
我们确定了43300例CD患者和198532名匹配的对照个体。在中位随访时间11.4年后,CD患者和对照个体的皮肤病发病率分别为每1000人年22.6例和14.8例(风险比[HR],1.55;95%置信区间[CI],1.51 - 1.58)。湿疹(HR,1.67;95% CI,1.56 - 1.79)、银屑病(HR,1.55;95% CI,1.43 - 1.68)、荨麻疹(HR,1.52;95% CI,1.42 - 1.64)、白癜风(HR,1.90;95% CI,1.52 - 2.39)、痤疮(HR,1.39;95% CI,1.29 - 1.50)和斑秃(HR,1.78;95% CI,1.43 - 2.20)的风险增加。
与普通人群相比,CD患者患多种常见皮肤病的风险增加,且这种风险长期存在。