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Incidence of autoimmune diseases in patients with scabies: a nationwide population-based study in Taiwan

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Abstract

Scabies is a commonly occurring infectious immune-mediated inflammatory skin disease. Immune-mediated inflammatory processes are also observed in autoimmune diseases. There have been very few previous studies; however, that have investigated the possible association between scabies and autoimmune diseases. To address this research gap, we conducted a nationwide population-based cohort study that included a total of 4481 scabies patients and 16,559 control subjects matched by gender, age, insured region, urbanization and income. We tracked both cohorts for a 7-year period to identify the incidence of autoimmune diseases in both groups during that follow-up period. Relatedly, a Cox regression analysis was performed to calculate and compare the hazard ratio (HR) for autoimmune diseases of both groups. An overall increased risk for 19 autoimmune diseases was observed in the scabies patients, with an adjusted HR (aHR) of 1.14 (95% CI 1.04–1.25). Compared with the control group, the scabies patients exhibited increased risks of hypersensitivity vasculitis (aHR 5.44, 95% CI 1.64–18.07), dermatomyositis (aHR 4.91, 95% CI 1.80–13.38), polyarteritis nodosa (aHR 2.89, 95% CI 1.46–5.73), systemic lupus erythematosus (aHR 2.73, 95% CI 1.33–5.64), psoriasis (aHR 2.31, 95% CI 1.85–2.88), myasthenia gravis (aHR 2.01, 95% CI 1.31–3.12), type 1 diabetes mellitus (aHR 1.93, 95% CI 1.53–2.44), pernicious anemia (aHR 1.92, 95% CI 1.42–2.61), and rheumatoid arthritis (aHR 1.43, 95% CI 1.12–1.83). In conclusion, the associations between scabies and a variety of autoimmune diseases may exist. Further studies are needed to clarify the shared etiologies and relationships between scabies and autoimmune diseases.

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Abbreviations

aHR:

Adjusted hazard ratio

CI:

Confidence interval

DM:

Diabetes mellitus

HR:

Hazard ratio

ICD-9-CM:

The International Classification of Diseases, Ninth Revision, Clinical Modification

IL:

Interleukin

NHI:

National Health Insurance

NHIRD:

National Health Insurance Research Database

LHID2000:

Longitudinal Health Insurance Database 2000

SLE:

Systemic lupus erythematosus

Th17:

T helper 17 cells

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Authors and Affiliations

  1. Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, No. 1492, Chung-Shan Road, Taoyuan District, Taoyuan, 330, Taiwan

    Jui-Ming Liu

  2. Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan

    Jui-Ming Liu

  3. Graduate Institute of Life Sciences, National Defense Medical Center, No. 161, Sec. 6, Minquan E. Road, Neihu District, Taipei, 114, Taiwan

    Jui-Ming Liu & Ren-Jun Hsu

  4. Department of Emergency Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, 235, Taiwan

    Feng-Hsiang Chiu

  5. Superintendent Office, Ningbo Medical Center, Lihuili Eastern Hospital, Ningbo City, 315000, Zhejiang Province, PR China

    Feng-Hsiang Chiu

  6. Department of Pediatrics, Hsinchu MacKay Memorial Hospital, No. 690, Sec. 2, Guangfu Road, Hsinchu, 300, Taiwan

    Chien-Yu Lin

  7. Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Fung-Wei Chang

  8. Department of Pathology and Graduate Institute of Pathology and Parasitology, The Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Ren-Jun Hsu

  9. Biobank Management Center of The Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Ren-Jun Hsu

Authors
  1. Jui-Ming Liu
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Corresponding author

Correspondence to Ren-Jun Hsu.

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Funding

The work was supported by grants from the Ministry of Science and Technology Taiwan (MOST 104-2320-B-016-012-MY3), the Tri-Service General Hospital (TSGH-C105-168, TSGH-C106-148), and Taoyuan General Hospital, Ministry of Health and Welfare (10602) in the analysis and interpretation of data. The results presented in this study do not represent the official opinions of the Bureau of National Health Insurance, the Tri-Service General Hospital, the Department of Health, or the National Health Research Institute.

Conflict of interest

Jui-Ming Liu declares that he has no conflict of interest. Feng-Hsiang Chiu declares that he has no conflict of interest. Fung-Wei Chang declares that he has no conflict of interest. Chien-Yu Lin declares that he has no conflict of interest. Ren-Jun Hsu declares that he has no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

This retrospective study was approved by the Institutional Review Board of the Tri-Service General Hospital (Approval Number: TSGHIRB B-105-06). All data was anonymous and the Institutional Review Board did not require patient consent be obtained.

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Liu, JM., Chiu, FH., Lin, CY. et al. Incidence of autoimmune diseases in patients with scabies: a nationwide population-based study in Taiwan. Rheumatol Int 37, 1125–1134 (2017). https://doi.org/10.1007/s00296-017-3717-2

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  • DOI: https://doi.org/10.1007/s00296-017-3717-2

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