Children with mild atopic dermatitis are 12% more likely to experience a fracture, suggests a recent Korean study published in the journal Allergy.¹ Among children with moderate to severe disease, the likelihood of a fracture increased by 23%.

Over an average follow-up period of 7.52 years in this study of nearly 1.78 million children, 19% children were diagnosed with atopic dermatitis. After adjusting for confounding variables, the risk of fractures in children with atopic dermatitis was 14% higher compared to the control group in the matched cohort; 33.37 versus 28.88 per 1,000 person-years. The risk increased as the severity of the disease increased; 28.88 per 1,000 person-years in the control group, 33.08 in children with mild atopic dermatitis and 35.54 in children with moderate-to-severe AD.

The adjusted hazard ratio (aHR) was 1.19 in children diagnosed with atopic dermatitis at <2 years of age; the aHR was 1.08 for age at diagnosis of 2-4 years and 1.03 for children diagnosed at the age of ≥5 years. The fracture risk was similar at different sites. The aHR for fracture spine was 1.33; for head, aHR was 1.13; for upper limb, the aHR was 1.06; for lower limb, it was 1.13. The aHR for fractures at other sites was 1.21.

According to the authors, an interplay of many factors such as diet, intake of calcium and vitamin D, physical activity, sleep, psychological/behavioral disorders, systemic steroids, immunity may contribute to the heightened risk of fractures in children with atopic dermatitis.

Reference

1. Lee SW, et al. Fracture incidence in children after developing atopic dermatitis: A Korean nationwide birth cohort study. Allergy. 2022 Nov 9. doi: 10.1111/all.15577.