Patients with atopic dermatitis are at increased risk of venous thromboembolism (VTE), suggests a study from Taiwan published online May 31 in JAMA Dermatology.¹

In this study, Tai-Li Chen and coauthors investigated the risk of new onset VTE in patients with atopic dermatitis. For this they selected adults who had been newly diagnosed with AD between 2003 and 2017 and matched controls from the National Health Insurance Research Database. A total of 284,858 matched participants were recruited for the study; both groups had 142,429 participants each. AD patients were further categorized into subgroups according to the disease severity. Both groups had female preponderance. The average age of participants was around 44 years in both groups.

Over the follow-up period, it was found that 0.7% of patients with AD developed VTE corresponding to incidence rate of 1.05 per 1000 person-years, while in the control group, 0.6% patients developed VTE with incidence rate of 0.82 per 1000 person-years. Compared to those without AD, the risk of incident VTE was considerably higher among patient with AD with hazard ratio (HR) of 1.28. The HR for deep vein thrombosis (DVT) was 1.26 and that for pulmonary embolism (PE) was 1.30.

AD is a chronic inflammatory condition of the skin and inflammation increases prothrombotic factors and may trigger VTE. This study demonstrates the increased risk of VTE in AD, which can potentially be fatal. Hence, all adult patients with AD should be regularly assessed for cardiovascular risk and they should undergo prompt evaluation if they have symptoms suggestive of VTE such as swelling and tenderness in the legs (DVT) or sudden onset of shortness of breath and pain on breathing (PE). Although the difference between the two groups was small, nevertheless physicians treating these patients should be aware of this association and remain alert to these symptoms and also educate their patients about the same.

Reference

1. Chen TL, et al. Risk of venous thromboembolism among adults with atopic dermatitis. JAMA Dermatol. 2023 May 31. doi: 10.1001/jamadermatol.2023.1300.