Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.
Center of Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
J Eur Acad Dermatol Venereol. 2022 Mar;36(3):413-421. doi: 10.1111/jdv.17789. Epub 2021 Nov 30.
Atopic dermatitis (AD) is a chronic inflammatory skin disease with a multifactorial genesis including genetic predispositions and environmental risk and trigger factors. One of the latter possibly is smoking, indicated by an increased prevalence of AD in adults and children that are actively or passively exposed to cigarette smoke.
In this study, AD characteristics and its atopic comorbidities are compared in smoking and non-smoking AD patients.
TREATgermany is a non-interventional clinical registry which includes patients with moderate to severe AD in Germany. Baseline data of patients included in TREATgermany from inception in June 2016 to April 2020 in 39 sites across Germany was analysed comparing AD disease characteristics and comorbidities in smokers vs. non-smokers.
Of 921 patients, 908 (male: 58.7%) with a mean age of 41.9 ± 14.4 reported their smoking status. The objective Scoring of Atopic Dermatitis (oSCORAD) did not differ between smokers (n = 352; 38.8%) and non-smokers, however, lesions' intensity of oozing/crusts and excoriations as well as patient global assessment scores (PGA) of AD severity were higher in smoking as opposed to non-smoking patients. Smokers reported a lower number of weeks with well-controlled AD and more severe pruritus than non-smokers. Total IgE levels were more elevated in smokers and they displayed a younger age at the initial diagnosis of bronchial asthma. After adjustment for potential confounders, the increased intensity of oozing/crusts, the reduced number of weeks with well-controlled AD and the greater pruritus remained different in smokers compared to non-smokers. In addition, smoking patients with adult-onset AD showed a 2.5 times higher chance of involvement of the feet.
German registry data indicate that AD patients who smoke have a higher disease burden with a different distribution pattern of lesions in adult-onset AD.
特应性皮炎（AD）是一种慢性炎症性皮肤病，其发病机制具有多因素性，包括遗传易感性和环境风险及触发因素。后者之一可能是吸烟，这表现为主动或被动接触香烟烟雾的成年人和儿童中 AD 的患病率增加。
本研究比较了吸烟和非吸烟 AD 患者的 AD 特征及其特应性合并症。
TREATgermany 是一项非干预性临床登记研究，纳入了德国中重度 AD 患者。对 2016 年 6 月至 2020 年 4 月期间在德国 39 个地点纳入 TREATgermany 的患者的基线数据进行了分析，比较了吸烟者和非吸烟者的 AD 疾病特征和合并症。
921 例患者中，908 例（男性：58.7%）报告了吸烟状况，年龄为 41.9±14.4 岁。吸烟者（n=352；38.8%）和非吸烟者的客观特应性皮炎评分（oSCORAD）无差异，但渗出/结痂和搔抓的病变严重程度以及 AD 严重程度的患者总体评估（PGA）评分在吸烟者中更高。与非吸烟者相比，吸烟者报告 AD 控制良好的周数较少，瘙痒更严重。吸烟者的总 IgE 水平更高，且支气管哮喘的初始诊断年龄更小。在调整了潜在混杂因素后，与非吸烟者相比，渗出/结痂的严重程度增加、AD 控制良好的周数减少和瘙痒程度增加在吸烟者中仍然存在差异。此外，成年起病的 AD 吸烟者出现足部受累的几率高 2.5 倍。
德国登记数据表明，吸烟的 AD 患者疾病负担更高，且成人起病的 AD 病变分布模式不同。
