People with atopic eczema may have an increased chance of death from all causes – particularly infectious diseases – suggests a new study published in the Journal of Allergy and Clinical Immunology. With atopic eczema impacting 10-20% of children and up to 10% of adults worldwide, the results give important insight into how allergy-related conditions may have drastic impacts on overall health.
"Recent evidence has led to a paradigm shift in how atopic eczema is perceived, from focusing on skin symptoms and associated allergic diseases, to understanding that the disease may be associated with a range of important medical outcomes. Recently, we found atopic eczema to be associated with an increased risk of myocardial infarction, ischemic stroke, angina and heart failure.” said Sinéad Langan, Professor of Clinical Epidemiology at LSHTM, in a statement.
"However, few studies have assessed if atopic eczema increases the risk of death, a research question we aimed to address in this study."
The study covered over 3 million records of patients that died in the UK from 1998 to 2016, looking for differences between those with atopic eczema and those without. The researchers, from the London School of Hygiene & Tropical Medicine, also aimed to determine whether the severity of eczema changes the risks of all-cause mortality.
The results demonstrated a weak – but significant – correlation between people with atopic eczema and death from all causes, with an associated 4% risk increase. Diseases that were used as part of all-cause mortality included 15 different distinct causes including respiratory, circulatory and digestive diseases.
However, the more interesting results came from associations with increased eczema severity and all-cause mortality. Patients with severe manifestations of atopic eczema had a 62% higher risk of dying than those without, with the largest increases seen in death by infections. The reason why is not yet understood, but the researchers express a strong need to understand the underlying mechanisms behind the increase in death rate.
This study represents the largest look into the relationship between atopic eczema, all-cause mortality and cause-specific mortality. The findings are in line with previous studies that identified an increased risk of various serious conditions and eczema, suggesting there is a definite link between the two. However, the authors recognize the limitations of the study methodology, in which selection bias – picking subjects related to the study that may not be representative of the population – may skew the data, but steps were taken throughout to limit this as much as possible. Studies such as this serve as a starting point for future lines of inquiry.
"Although the absolute risk of death from severe eczema is low, our findings suggest that those with severe or more active forms of the disease do face a higher risk of dying from associated health issues. We hope that this new information will help inform further research to better understand this pattern and the underlying mechanisms of these associations, and subsequently inform and improve treatment processes for those with severe eczema." Said Professor Langan.