Nav: Home

Atopic eczema linked to increase fracture risk in adults

November 20, 2019

Involving the health records of three million adults in the UK, the study, led by the London School of Hygiene & Tropical Medicine, is the largest to date examining the relationship between atopic eczema and fractures, and the first using primary care data.

It found that risk of any fracture was up to 13% greater in people with atopic eczema compared to people without. People with severe atopic eczema had a dramatically increased risk of fracture: 50% more hip fractures, 66% more pelvis fractures, and more than double the risk of spine fractures.

The researchers highlight that the overall risk remains low, with the study estimating that in 100,000 people with atopic eczema, an extra 164 people would break a bone compared to the number of broken bones that would be expected in a group of 100,000 people without atopic eczema of the same age and sex. However, they say the results are of public health importance given how common atopic eczema is and that broken bones can cause illness and death.

Importantly, the increased risk of fracture in people with atopic eczema persisted even after the researchers accounted for oral corticosteroids - drugs that are used to treat eczema that are linked to increased fracture risk.

Professor Sinéad Langan from the London School of Hygiene & Tropical Medicine and senior author of the study said: "Previous research has shown associations between atopic eczema and osteoporosis, a condition that weakens bones and makes them more likely to break, and between atopic eczema and fracture. However, this is the first evidence that eczema precedes fractures and that fracture risk increases with more severe eczema."

Atopic eczema is a common skin condition, affecting 1 in 5 children and up to 1 in 10 adults in the UK and is becoming more common globally. Of those with atopic eczema, 30% have moderate to severe disease with approximately 5% having severe disease. Symptoms include intense itch, pain, sleeplessness and low self-esteem.

Using UK electronic health records between 1998 and 2016 from the Clinical Practice Research Datalink and Hospital Episode Statistics, the researchers matched patients diagnosed with eczema and those without eczema on age, sex, general practice and calendar time. After adjusting for other factors such as socioeconomic status, age, body mass index and harmful alcohol use, the researchers examined the differences in increased risk of major osteoporotic fractures - hip, pelvis, spine, proximal humerus, and wrist) between the two groups.

There was strong evidence of an association between atopic eczema and increased hip, pelvic, spinal and wrist fractures. There was weaker evidence for an increase in proximal humeral fractures. The greatest increased risk was seen for spinal fracture.

Professor Langan said: "Although the overall risk is low, the substantial increase in the risk of spine, hip and pelvic fractures seen in those with severe atopic eczema is particularly concerning, given the serious health issues associated with these fractures. Atopic eczema is currently not considered a risk factor for fracture. Our results suggest that bone density screening guidelines should consider including individuals with more severe atopic eczema in order to prevent fractures, improve long-term quality of life, and reduce fracture-related healthcare costs.

"Future work should focus on determining the possible biological mechanisms linking atopic eczema to lowered bone density, and whether targeted screening and intervention would benefit individuals with atopic eczema."

Co author Amanda Roberts from the Nottingham Support Group for Carers of Children with Eczema, said: "This work highlights an important link that, if established sooner, could have helped saved my mother who had eczema all her life and died following a hip fracture. I hope our findings lead to new prevention strategies that help improve future care for those with eczema."

The researchers acknowledge limitations of their study including the possibility that there may be other reasons explaining why people with atopic eczema may be more likely to break bones. For example, people with eczema may have daily allergies, make dietary changes (some believe that certain foods trigger eczema flares) or avoid exercise (as sweating may increase the itch associated with their atopic eczema); these factors may make them more prone to fractures.
The study was funded by the Wellcome Trust.

London School of Hygiene & Tropical Medicine

Related Eczema Articles:

NIH-supported scientists demonstrate how genetic variations cause eczema
New research supported by the National Institutes of Health delineates how two relatively common variations in a gene called KIF3A are responsible for an impaired skin barrier that allows increased water loss from the skin, promoting the development of atopic dermatitis, commonly known as eczema.
Biomedical researchers get closer to why eczema happens
A new study from researchers at Binghamton University, State University of New York may help to peel back the layers of unhealthy skin -- at least metaphorically speaking -- and get closer to a cure.
Researchers uncover novel approach for treating eczema
Researchers at the University of British Columbia (UBC) and Vancouver Coastal Health Research Institute (VCHRI) have identified a key enzyme that contributes to eczema, which may lead to better treatment to prevent the skin disorder's debilitating effects.
Revving up immune system may help treat eczema
Studying eczema, researchers at Washington University School of Medicine in St.
Childhood eczema cannot be prevented by daily moisturiser use, study finds
Using moisturisers on newborn babies does not prevent eczema as previously thought, according to a major new study.
Atopic eczema linked to increase fracture risk in adults
Adults with atopic eczema could face a raised risk of fracture, with the risk increasing the more severe the condition, according to a new study published in the Journal of Allergy and Clinical Immunology.
Long-term dupilumab benefits adolescents with eczema
Results from a phase IIa open-label trial and a subsequent phase III open-label extension trial reinforce findings from an earlier short-term trial that adolescents with moderate-to-severe atopic dermatitis, or eczema, can experience significant improvements with dupilumab.
Multiple genes affect risk of asthma, hay fever and eczema
In a new study from SciLifeLab at Uppsala University, researchers have found a total of 141 regions (genes) in our genetic material that largely explain the genetic risk underlying asthma, hay fever and eczema.
Cracks in the skin of eczema patients promote allergic diseases
Many babies with eczema go on to develop food allergies, asthma and hay fever, and researchers at National Jewish Health say it's not a coincidence.
How scratching may prime children with eczema for food allergy and anaphylaxis
Eczema, a chronic itchy inflammatory skin disease, affects about 15 percent of U.S. children.
More Eczema News and Eczema Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Debbie Millman: Designing Our Lives
From prehistoric cave art to today's social media feeds, to design is to be human. This hour, designer Debbie Millman guides us through a world made and remade–and helps us design our own paths.
Now Playing: Science for the People

#574 State of the Heart
This week we focus on heart disease, heart failure, what blood pressure is and why it's bad when it's high. Host Rachelle Saunders talks with physician, clinical researcher, and writer Haider Warraich about his book "State of the Heart: Exploring the History, Science, and Future of Cardiac Disease" and the ails of our hearts.
Now Playing: Radiolab

Insomnia Line
Coronasomnia is a not-so-surprising side-effect of the global pandemic. More and more of us are having trouble falling asleep. We wanted to find a way to get inside that nighttime world, to see why people are awake and what they are thinking about. So what'd Radiolab decide to do?  Open up the phone lines and talk to you. We created an insomnia hotline and on this week's experimental episode, we stayed up all night, taking hundreds of calls, spilling secrets, and at long last, watching the sunrise peek through.   This episode was produced by Lulu Miller with Rachael Cusick, Tracie Hunte, Tobin Low, Sarah Qari, Molly Webster, Pat Walters, Shima Oliaee, and Jonny Moens. Want more Radiolab in your life? Sign up for our newsletter! We share our latest favorites: articles, tv shows, funny Youtube videos, chocolate chip cookie recipes, and more. Support Radiolab by becoming a member today at