Summer 2018 | Live Blog | Comorbidities in Psoriasis: Fact or Fiction?
Did you know that over 20 comorbidities have been linked to Atopic Dermatitis in 2018? Dr. Robert Sidbury from Seattle Children’s Hospital helped attendees of the SDPA Summer Conference sift through the published data related to atopic comorbidities. Dr. Sidbury relayed that it is an “incredibly dynamic” time in the field of atopy in both the realm of therapeutic advances and in the development of literature of atopic comorbidities.
Although, food allergy is considered a conventional comorbidity of atopy with 30% of patients with atopy revealing that they are sensitized to at least one food, the vast majority of this group rarely improve or clear with an elimination diet. In addition to the conventional comorbidities of the atopic “march”, newer relationships that are being investigated include ADHD, autism, obesity and anemia.
Earlier onset and more severe atopic dermatitis seem to increase the risk of comorbidities. This leads to the question; can atopy be prevented? Recent studies have found that the less epidermal water loss in the beginning of life, the lower the rates of eczema. Prevention of water loss can be accomplished through emollient use within the first three weeks of life—with one study revealing a 50% decrease in the development of atopic dermatitis. Dr. Sidbury relates that moisturizing is an “unambiguous good” for those patients who suffer atopic dermatitis.
In regards to newly identified comorbidities, there are now multiple studies revealing a positive correlation with atopic dermatitis and ADHD. This relationship is related to the severity of the condition—the more severe a patient’s atopy, the more likely they will have ADD/ADHD. Due to these and other comorbidity findings with atopy, the AAD recommends that providers “be aware of and assess for conditions associated with atopic dermatitis such as rhinitis/conjunctivitis, asthma, food allergy, sleep disturbance, depression, and other neuropsychiatric conditions”. He highlighted that sleep disturbances are a significant problem in kids with atopic dermatitis and ADHD.
Lastly, the quality of life for individuals and families of individuals of eczema can be severely affected. Dr. Sidbury recommends the National Eczema Association as a resource for both patients and families. Moderate to severe atopic dermatitis impacts quality of life “comparably to cystic fibrosis, chronic kidney disease and asthma”. Itch and sleep loss are listed as the main negative impacts on quality of life.