只處理皮膚病灶就可以了嗎？普查十萬名成人異位性皮膚炎患者：受苦的不只是皮膚，多會合併其它疾患，皮膚病況嚴重者更是如此 - 瑞典研究

關於普查三萬名兒童異位性皮膚炎患者的研究，發現這些兒童異位性皮膚炎患者受苦的不只是皮膚，往往會合併其它疾患，如氣喘、過敏性鼻炎、身心症、腸躁症等。

那成人呢?

依據瑞典普查十萬名成人異位性皮膚炎患者的研究，“Comorbidity burden in adult atopic dermatitis：A population‐based study（外部網站）”，發現成人異位性皮膚炎患者如同兒童異位性皮膚炎患者一樣，不只皮膚出狀況，往往會合併其他疾病。

而且當皮膚病況越嚴重，越是如此。

臨床來看，異位性皮膚炎時常合併睡眠障礙、消化問題、氣喘、過敏性鼻炎、身心問題以及社交障礙。

不只治療皮膚，並同步處理多個身體不適，讓皮膚達到從裡到外的改變，正是中醫所擅長的。

有些人認為異位性皮膚炎就是基因的問題，所以無法改變，只能終生壓制症狀。

我認為基因就像種子一樣，我們無法改變基因，但我們可以改變土壤，也就是所謂的「體質」。

當土壤被改變了，就能扭轉種子發芽與否，而不是要終身「治療」。

本篇研究，全文請見這裡（外部網站），期刊摘要如下：

Background：

Atopic dermatitis (AD) is a chronic inflammatory skin disease that has been shown to be associated with allergic comorbidities. However, studies examining comorbidities in patients with AD are incomplete, which may contribute to suboptimal care.

Objectives：

The objective was to compare the risk of developing different allergic and non-allergic comorbidities among adult patients with AD to that of a matched reference cohort in Sweden.

Methods：

This was a nationwide, population-based cohort study using longitudinal data from primary and specialist care registers. AD patients were identified by confirmed diagnosis in primary or specialist care. A non-AD reference cohort was randomly drawn from the general population and matched 1:1 with the AD patients based on age, gender, and geographical region.

The risk of developing the following conditions was evaluated: asthma, food hypersensitivity, allergic rhinitis, neurological disorders, psychiatric disorders, infections, immunological & inflammatory disorders, type 1 diabetes (T1D), type 2 diabetes (T2D), endocrine & metabolic disorders, skeletal disorders, ocular disorders, cardiovascular diseases, and malignancies.

Results：

This study included 107,774 AD patients [mild-to-moderate (n = 92,413) and severe (n = 15,361)] and an equally sized reference cohort. AD patients displayed a higher risk of developing comorbid conditions for all investigated categories, except for T1D, compared with the reference cohort.

The highest risk compared with the reference cohort was observed for allergic comorbidities, followed by immunological & inflammatory disorders (hazard ratio: 2.15) and infections (hazard ratio: 2.01). Patients with AD also had a higher risk of developing multiple comorbidities (two or more). The risk of comorbidity onset increased alongside AD severity, and patients with active AD were associated with an increased risk of comorbidity onset compared with patients in remission.

Conclusions：

AD patients are at an increased risk of developing many comorbidities that extend beyond allergic conditions. This study highlights the need for interdisciplinary follow-up of comorbidities in the management of AD patients to reduce overall patient burden.

原始論文

Comorbidity burden in adult atopic dermatitis: A population-based study（外部網站）

Thyssen JP, Henrohn D, Neary MP, Geale K, et al. JEADV Clinical Practice. 2024;3(1):128-141. doi:10.1002/jvc2.303

論文摘要（Google 翻譯）

以下為 Google 翻譯，並校正明顯錯誤，僅供參考，內容以英文原文為準。

成人異位性皮膚炎的共病負擔：一項以族群為基礎的研究

背景：異位性皮膚炎（AD）是一種慢性發炎性皮膚病，已證實與過敏性共病有關。然而，探討 AD 患者共病的研究並不完整，可能導致照護不夠理想。

目的：比較瑞典成年 AD 患者與配對參考世代發生各種過敏性與非過敏性共病的風險。

方法：這是一項全國性、以族群為基礎的世代研究，使用基層醫療與專科醫療登記資料庫的縱向資料。AD 患者以基層或專科醫療中的確診紀錄認定。非 AD 參考世代從一般族群中隨機抽取，並依年齡、性別與地理區域與 AD 患者 1:1 配對。

評估發生下列疾病的風險：氣喘、食物過敏、過敏性鼻炎、神經系統疾病、精神疾病、感染、免疫與發炎性疾病、第 1 型糖尿病（T1D）、第 2 型糖尿病（T2D）、內分泌與代謝疾病、骨骼疾病、眼部疾病、心血管疾病及惡性腫瘤。

結果：本研究納入 107,774 名 AD 患者［輕度至中度（n = 92,413）及重度（n = 15,361）］與同等人數的參考世代。與參考世代相比，AD 患者在所有研究類別（T1D 除外）發生共病的風險都較高。

與參考世代相比，風險最高的是過敏性共病，其次為免疫與發炎性疾病（風險比：2.15）與感染（風險比：2.01）。AD 患者發生多重共病（兩種或以上）的風險也較高。共病發生風險隨 AD 嚴重度增加而上升，且病情活動中的 AD 患者比緩解期患者的共病發生風險更高。

結論：AD 患者發生多種共病的風險增加，且不限於過敏性疾病。本研究強調在 AD 患者的照護中，需要跨專科追蹤共病，以減輕患者的整體負擔。

異位性皮膚炎，中醫經方的治療實例，請見這裡。

小兒異位性皮膚炎，中醫經方的治療實例，請見這裡。

成人異位性皮膚炎，中醫經方的治療實例，請見這裡。

異位性皮膚炎，期刊研究，請看這裡。

期刊研究整理，請見這裡。