Comorbidity Prevalence Highlighted for Conditions Such as Psoriasis, Vitiligo

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Patients with dermatologic conditions—particularly atopic dermatitis and psoriasis—may have a greater prevalence and incidence of conditions such as lymphoma, venous thromboembolism, new findings suggest, as opposed to those without such diseases.¹

These data resulted from new research examining the rates of prevalence and incidence of various comorbidities in patients from Japan with psoriasis, vitiligo, alopecia areata, atopic dermatitis. This new research was authored by such investigators as Shinichi Imafuku, from the department of dermatology at Fukuoka University in Japan

Imafuku and colleagues looked at the rates of malignancies, infections, and cardiovascular diseases among patients with the 4 aforementioned dermatologic conditions. The investigators noted that recent retrospective research had highlighted a number of comorbidities in atopic dermatitis specifically.²

“To better inform clinical management and support patient care, this retrospective real-world study aimed to estimate the prevalence and IRs of comorbidities, including CVDs, malignancies, infections, and dermatologic and allergic conditions, in patients from Japan with [atopic dermatitis], psoriasis, [alopecia areata], and vitiligo using the JMDC claims database,” Ma and colleagues wrote.¹

Assessing Incidence and Prevalence of Comorbidities for Dermatologic Conditions

The investigators conducted a retrospective cohort study in which they analyzed data sourced from the JMDC claims database compilation of health insurance claims. Approximately 6.1% of the Japanese population is represented in this database, according to a 2019 feasibility assessment.

The period in which the analysis took place occurred from June 2013 - December 2020, with eligibility for inclusion determined by the research team based on diagnostic records within the JMDC database between June 2014 - December 2020. The team implemented an anonymized, structured dataset that would contain no personally identifiable data.

There were 4 cohorts used in this analysis—psoriasis, atopic dermatitis, alopecia areata, and vitiligo—with participants required to have reported at least 2 confirmed diagnoses recorded in different months. Within the prior year, at least 1 of these diagnoses had to be documented after entry into the database.

The investigative team also had a variety of other criteria for inclusion in the study, with those the psoriasis cohort, for example, being required to have received at least 2 treatments within a month of diagnosis. Those included in the atopic dermatitis cohort were required to have at least 2 treatment records within a single month of their confirmed diagnosis as well. They identified the health conditions through ICD-10-coded database records during the baseline period.

The total number of subjects included in the treatment cohort was as follows: 51,988 in the psoriasis arm, 691,338 in the atopic dermatitis arm, 43,692 in the alopecia areata arm, and 8,912 in the vitiligo arm. The team matched each trial participant with these diseases 1:1 with a control participant.

The investigators based the matches on index month, sex, and age. with an equal number of matched controls. They compared the prevalence of comorbid conditions among the study subjects against their respective control cohorts.

Overall, the research team concluded that the prevalence and incidence of certain comorbidities were particularly higher among those with atopic dermatitis and psoriasis. They concluded that among those in the atopic dermatitis arm, the comorbidities that were shown to be most common versus matched controls included conjunctivitis (33% versus 23%), allergic rhinitis (47% versus 37%), viral infections (22% versus 15%), asthma (27% versus 20%), and acne (11% versus 3%).

Among those included in the atopic dermatitis cohort, rates of incidence per 100,000 person-years for specific conditions were significantly higher than those in the control arm, including cutaneous T-cell lymphoma (1.6; 95% CI, 1.1–2.2 versus 0.1; 95% CI, 0.0–0.4), lymphoma (13.8; 95% CI, 12.2–15.6 versus 5.7; 95% CI, 4.7–6.8), venous thromboembolism (51.4; 95% CI, 48.3–54.7 versus 31.7; 95% CI, 29.2–34.2), and herpes zoster (740.9; 95% CI, 728.8–753.1 versus 397.6; 95% CI, 388.9–406.6).

The investigative team also highlighted comparable patterns when they compared the psoriasis cohort to non-psoriasis controls. Additionally, it was noted in the team’s conclusion that those in the alopecia areata and vitiligo arms of the study demonstrated some overlap in confidence intervals with their respective control arms.

“Further research is needed to examine these associations and potential causal relationships between these comorbidities and [atopic dermatitis], psoriasis, [alopecia areata], and vitiligo,” they wrote. “Awareness of the risks of comorbidities in patients with skin diseases in Japan may inform clinician decision-making around disease management.”¹

References

1. Ma Y, Chachin M, Hirose T, Nakamura K, Shi N, Hiro S, et al. Prevalence and incidence of comorbidities in patients with atopic dermatitis, psoriasis, alopecia areata, and vitiligo using a Japanese claims database. J Dermatol. 2025; 00: 1–14. https://doi.org/10.1111/1346-8138.17643.

2. Campos-Alberto E, Hirose T, Napatalung L, Ohyama M. Prevalence, comorbidities, and treatment patterns of Japanese patients with alopecia areata: a descriptive study using Japan medical data center claims database. J Dermatol. 2023; 50: 37–45.