Inflammatory bowel disease associated with chronic inflammatory skin diseases

Written By : Dr.Niharika Harsha B |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2022-12-09T20:00:45+05:30 | Updated On 9 Dec 2022 8:00 PM IST

A new study revealed that inflammatory bowel disease was associated with various chronic inflammatory skin diseases. IBD incidence was increased in patients with hidradenitis suppurativa, and CD was increased in patients with psoriasis. The study results were published in the journal British Journal of Dermatology.

Several studies done in the past have linked various chronic inflammatory skin diseases (CISDs) with inflammatory bowel disease (IBD). But there are mixed conclusions hence researchers conducted a study to compare the incidence of IBD – ulcerative colitis (UC) and Crohn's disease (CD) – in patients with a CISD vs. similar persons without a CISD.

Using nationwide, longitudinal, commercial insurance claims data from the USA, a cohort study was done on adults and children between 2004 and 2020 diagnosed with either psoriasis, atopic dermatitis, alopecia areata, vitiligo, or hidradenitis suppurativa. Comparator patients were identified through risk-set sampling. They were considered eligible if they were seen by a dermatologist at least twice and not diagnosed with a CISD. Patient follow-up was done until either IBD diagnosis, death, disenrollment, or end of the data stream, whichever came first. IBD events, UC or CD, were identified via validated algorithms using hospitalization or diagnosis with endoscopic confirmation. Incidence rates were computed before and after adjustment via propensity-score decile stratification to account for IBD risk factors. Hazard ratios (HR) and 95% confidence intervals (CIs) were estimated to compare the incidence of IBD in CISD vs. non-CISD.

Results:

There were 123 614 patients with atopic dermatitis,83 049 patients with psoriasis, 18 135 patients with alopecia areata, 9003 patients with vitiligo or 6806 patients with hidradenitis suppurativa, and 2 376 120 comparator patients without a CISD.
An increased risk of both UC and CD in patients with hidradenitis suppurativa, an increased risk of CD but not UC in psoriasis, and no increased risk of IBD in atopic dermatitis, alopecia areata, or vitiligo was seen during a median follow-up time of 718 days, and after applying propensity-score adjustment for IBD risk factors.

Take-home points:

By providing background rates for IBD across multiple CISDs using consistent methods and within a single, nationally representative patient population, this large-scale, claims-based cohort study expands current knowledge.
A relatively increased risk of IBD was observed in patients with hidradenitis suppurativa, but the overall incidence rate difference of IBD was generally low.
Patients with psoriasis had an increased risk of Crohn's disease only, but patients with atopic dermatitis, vitiligo, or alopecia areata did not have an increased risk of either Crohn's disease or ulcerative colitis.

Further reading: Schneeweiss MC, Kirchgesner J, Wyss R, et al. Occurrence of inflammatory bowel disease in patients with chronic inflammatory skin diseases: a cohort study. Br J Dermatol. 2022;187(5):692-703. doi:10.1111/bjd.21704

chronic inflammatory skin diseasesinflammatory bowel diseaseulcerative colitisCrohn diseaseIBDUCCDCISDpsoriasisatopic dermatitisalopecia areatahidradenitis suppurativavitiligo

Source : British Journal of Dermatology

Dr.Niharika Harsha B

BDS, MDS

Dr.Niharika Harsha B (BDS,MDS) completed her BDS from Govt Dental College, Hyderabad and MDS from Dr.NTR University of health sciences(Now Kaloji Rao University). She has 4 years of private dental practice and worked for 2 years as Consultant Oral Radiologist at a Dental Imaging Centre in Hyderabad. She worked as Research Assistant and scientific writer in the development of Oral Anti cancer screening device with her seniors. She has a deep intriguing wish in writing highly engaging, captivating and informative medical content for a wider audience. She can be contacted at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751