Young Adults with Severe Eczema Face Nearly Three-Fold Higher Risk of Venous Thromboembolism: Study Finds
Sweden: A recent large-scale Swedish study published in the British Journal of Dermatology has revealed that individuals with severe atopic dermatitis (AD) face a significantly higher risk of developing venous thromboembolism (VTE)—a condition that includes deep vein thrombosis and pulmonary embolism—compared to the general population.
The research was led by Lina U. Ivert from the Division of Dermatology and Venereology at the Karolinska Institutet, Stockholm, Sweden, and colleagues.
Atopic dermatitis, a chronic inflammatory skin condition, affects millions worldwide, but its link with thrombotic complications has been unclear. To address this, the researchers conducted a nationwide population-based cohort study using Swedish health and population registers to assess whether AD increases the risk of VTE and how the risk varies with disease severity and age.
The study included 210,492 adults diagnosed with AD between 2006 and 2023, each matched by birth year and sex with up to five individuals from the general population without AD, forming a control group of over one million people. AD severity was determined based on whether patients had required systemic immunosuppressive therapy or hospitalization due to AD. Participants were followed from their first AD diagnosis (or 18th birthday) until the occurrence of VTE, emigration, death, or the end of the study period.
The study revealed the following findings:
- A total of 3,292 cases of venous thromboembolism were reported among individuals with atopic dermatitis during the study period.
- The incidence rate of VTE in the AD group was 1.49 per 1,000 person-years, similar to 1.71 per 1,000 person-years in the general population.
- After adjusting for comorbidities, treatments, and socioeconomic factors, the overall VTE risk in individuals with AD was nearly the same as in the general population (adjusted hazard ratio [aHR] 1.04).
- Patients with severe AD showed a 93% higher risk of developing VTE compared to those without AD (aHR 1.93).
- The increased risk in severe AD cases was consistent across all age groups.
- Younger adults aged 18–39 years with severe AD exhibited an almost three-fold higher risk of VTE than age-matched controls (aHR 2.95).
The researchers emphasized that while mild and moderate AD do not seem to increase clotting risk, severe forms of the disease are associated with a marked rise in thrombotic events, possibly due to systemic inflammation and immune dysregulation. They urged clinicians to remain vigilant for signs of VTE in young patients with severe AD, as early recognition and management could prevent serious complications.
The large nationwide analysis emphasizes that although most individuals with AD are not at greater risk of VTE, those with severe disease—especially younger adults—require closer clinical attention. The authors noted that further studies are needed to explore the biological mechanisms behind this association and to determine whether preventive strategies could reduce thrombotic risk in severe AD cases.
Reference:
Ivert, L. U., Gembert, K., Eriksson, J., Giunta, D. H., Hägg, D., & Linder, M. The Risk of Venous Thromboembolism in Atopic Dermatitis: A Population-Based Cohort Study. British Journal of Dermatology. https://doi.org/10.1093/bjd/ljaf418
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