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Low bone mineral density in adult patients with moderate to severe atopic dermatitis.
Br J Dermatol. 2009 Dec; 161(6):1248-54.BJ

Abstract

BACKGROUND

Atopic dermatitis (AD) is a chronic inflammatory skin disease commonly treated with topical corticosteroids. The inflammatory nature of this disorder and the use of topical corticosteroids represent potential risk factors for bone loss.

OBJECTIVES

The aim was to assess the prevalence of osteoporosis and osteopenia in adult patients with moderate to severe AD. In addition, the associations between topical/oral corticosteroid use and bone mineral density (BMD) and between disease activity and BMD were studied.

PATIENTS AND METHODS

We studied 125 adult patients with moderate to severe AD. Using dual-energy X-ray absorptiometry, BMD was measured at lumbar spine and hips. The cumulative dose of topical and oral corticosteroids was calculated from pharmacy prescription records. Lifestyle parameters were collected by a questionnaire. Biochemical parameters of bone metabolism and disease activity [serum concentration of thymus and activation-regulated chemokine (TARC) levels] were also measured.

RESULTS

Osteoporosis was documented in six patients (4.8%) and osteopenia in 41 patients (32.8%); 30.4% of the patients had a Z-score <or= -1 (low BMD), with more men (43.8%) than women (16.4%) affected. There was no significant association between low BMD and biochemical parameters of bone metabolism, serum TARC levels and cumulative dose of topical and oral corticosteroids during the 5 years prior to inclusion.

CONCLUSIONS

We document a Z-score <or= -1 in about one-third of predominantly male patients with moderate to severe AD, being independent of the cumulative dose of topical and corticosteroids used within 5 years prior to study. Whether the relatively high prevalence of low BMD is due to the cumulative dose of topical corticosteroids beyond 5 years prior to the study or the chronicity of the underlying inflammatory process or a combination of these, remains to be established.

Authors+Show Affiliations

Department of Dermatology and Allergology, University Medical Center Utrecht, Inhouse postnumber G02.124, Utrecht, the Netherlands. i.haeck@umcutrecht.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19673879

Citation

Haeck, I M., et al. "Low Bone Mineral Density in Adult Patients With Moderate to Severe Atopic Dermatitis." The British Journal of Dermatology, vol. 161, no. 6, 2009, pp. 1248-54.
Haeck IM, Hamdy NA, Timmer-de Mik L, et al. Low bone mineral density in adult patients with moderate to severe atopic dermatitis. Br J Dermatol. 2009;161(6):1248-54.
Haeck, I. M., Hamdy, N. A., Timmer-de Mik, L., Lentjes, E. G., Verhaar, H. J., Knol, M. J., de Bruin-Weller, M. S., & Bruijnzeel-Koomen, C. A. (2009). Low bone mineral density in adult patients with moderate to severe atopic dermatitis. The British Journal of Dermatology, 161(6), 1248-54. https://doi.org/10.1111/j.1365-2133.2009.09327.x
Haeck IM, et al. Low Bone Mineral Density in Adult Patients With Moderate to Severe Atopic Dermatitis. Br J Dermatol. 2009;161(6):1248-54. PubMed PMID: 19673879.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low bone mineral density in adult patients with moderate to severe atopic dermatitis. AU - Haeck,I M, AU - Hamdy,N A T, AU - Timmer-de Mik,L, AU - Lentjes,E G W M, AU - Verhaar,H J J, AU - Knol,M J, AU - de Bruin-Weller,M S, AU - Bruijnzeel-Koomen,C A F M, Y1 - 2009/06/04/ PY - 2009/8/14/entrez PY - 2009/8/14/pubmed PY - 2010/4/17/medline SP - 1248 EP - 54 JF - The British journal of dermatology JO - Br J Dermatol VL - 161 IS - 6 N2 - BACKGROUND: Atopic dermatitis (AD) is a chronic inflammatory skin disease commonly treated with topical corticosteroids. The inflammatory nature of this disorder and the use of topical corticosteroids represent potential risk factors for bone loss. OBJECTIVES: The aim was to assess the prevalence of osteoporosis and osteopenia in adult patients with moderate to severe AD. In addition, the associations between topical/oral corticosteroid use and bone mineral density (BMD) and between disease activity and BMD were studied. PATIENTS AND METHODS: We studied 125 adult patients with moderate to severe AD. Using dual-energy X-ray absorptiometry, BMD was measured at lumbar spine and hips. The cumulative dose of topical and oral corticosteroids was calculated from pharmacy prescription records. Lifestyle parameters were collected by a questionnaire. Biochemical parameters of bone metabolism and disease activity [serum concentration of thymus and activation-regulated chemokine (TARC) levels] were also measured. RESULTS: Osteoporosis was documented in six patients (4.8%) and osteopenia in 41 patients (32.8%); 30.4% of the patients had a Z-score <or= -1 (low BMD), with more men (43.8%) than women (16.4%) affected. There was no significant association between low BMD and biochemical parameters of bone metabolism, serum TARC levels and cumulative dose of topical and oral corticosteroids during the 5 years prior to inclusion. CONCLUSIONS: We document a Z-score <or= -1 in about one-third of predominantly male patients with moderate to severe AD, being independent of the cumulative dose of topical and corticosteroids used within 5 years prior to study. Whether the relatively high prevalence of low BMD is due to the cumulative dose of topical corticosteroids beyond 5 years prior to the study or the chronicity of the underlying inflammatory process or a combination of these, remains to be established. SN - 1365-2133 UR - https://www.unboundmedicine.com/medline/citation/19673879/Low_bone_mineral_density_in_adult_patients_with_moderate_to_severe_atopic_dermatitis_ L2 - https://doi.org/10.1111/j.1365-2133.2009.09327.x DB - PRIME DP - Unbound Medicine ER -