Individuals with AD are at relatively significant risk for the development of concomitant ED, hence, it is important to remain vigilant of the cutaneous manifestations of ED
Atopic dermatitis (AD) is a prevalent inflammatory skin disorder that impairs the quality of life of both the patient and the caregiver to a significant extent. This inflammatory skin disease is also associated with mental disorders in affected individuals, regardless of age. Prior research studies related to the comorbidities of AD lack significant data regarding the onset of eating disorders (EDs) in individuals with AD.
This Finnish nationwide retrospective registry-based study, published in the Journal of the American Academy of Dermatology, aimed to assess whether the risk of EDs is more significant in individuals with AD compared to the general population. The data regarding individuals with AD between 1987 and 2018 was acquired from the Finnish Care Register for Health Care database. Data of the study participants to be included in the control group was obtained from the Finnish Population Register Center database. In the given study, a total of 270,783 individuals were included in the control group, and 70,584 individuals with AD were included in the study group.
At the ages of 18 and 30, AD patients have relatively greater odds of having EDs than individuals in the control group, at the corresponding age. The highest association was recorded between AD and bulimia nervosa. This is followed by another ED, a binge eating disorder. It should be noted that the greater prevalence of food allergies in individuals with AD does not explain the onset of ED and AD.
The study findings suggest a positive association between EDs and AD. A negative cutaneous body image can explain the association between AD and the development of mental disorders, including EDs, among individuals with AD. Both AD and ED are associated with negative attitudes of AD patients towards eating, their bodies, and weight, as well as disturbed body image among these individuals. These factors also contribute to the maintenance of EDs in AD patients. The association between AD and the development of ED is also explained by pathophysiological mechanisms that involve immune response against self-antigens and immune dysregulation.
AD patients are at significant risk for the development of concomitant EDs. The results of this study suggest the need for increased awareness of the cutaneous manifestations of undiagnosed ED. It is also essential for physicians to discuss eating habits and the potential for anxiety around food with their AD patients.
Kauppi, S., Jokelainen, J., Timonen, M., Tasanen, K., & Huilaja, L. (2022). Atopic dermatitis and the risk of eating disorders: A population-based cohort study. J Am Acad Dermatol, 87(2), 474-476. https://doi.org/10.1016/j.jaad.2021.10.021