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Association of inflammatory skin diseases with venous thromboembolism in US adults

Abstract

Patients with certain inflammatory skin diseases have multiple risk factors for venous thromboembolism (VTE). The objective of the study was to determine whether atopic dermatitis (AD), psoriasis, pemphigus, pemphigoid and/or hidradenitis is associated with VTE in US adults. Data were analyzed from the 2002–2012 Nationwide Inpatient Sample, a representative cohort of US hospitalizations (N = 72,512,581 adults, including 1,389,292 with VTE). In multivariable logistic regression models including age, sex, insurance, household income and race/ethnicity, hospitalization for AD (adjusted odds ratio [95% confidence intervals] 1.22 [1.17–1.27]), pemphigus (1.96 [1.68–2.28]) and pemphigoid (1.64 [1.47–1.83]) was associated with VTE. These associations remained significant in virtually all patient subsets, including males and females, different age groups and those with and without long-term corticosteroid use. In particular, AD, pemphigus and pemphigoid were each associated with DVT and PE. VTE was associated with increased inpatient length of stay, cost of care and mortality across all the inflammatory skin diseases. HS and psoriasis were not consistently associated with VTE. AD, pemphigus and pemphigoid and some subsets of patients with HS were associated with higher odds of hospitalization for VTE. Patients with these inflammatory skin diseases may benefit from increased screening and prevention of VTE.

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Abbreviations

AD:

Atopic dermatitis

aOR:

Adjusted odds ratio

CI:

Confidence interval

HS:

Hidradenitis suppurativa

NIS:

Nationwide Inpatient Sample

DVT:

Deep vein thrombosis

PE:

Pulmonary embolus

VTE:

Venous thromboembolism

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Funding

This publication was made possible with support from the Agency for Healthcare Research and Quality (AHRQ), grant number K12 HS023011.

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JIS had full access to all the data in the study and takes responsibility for the integrity of the data and accuracy of the data analysis. Study concept and design: JIS and MSS. Acquisition of data: JIS and MSS. Analysis and interpretation of data: JIS and MSS. Drafting of the manuscript: JIS and MSS. Critical revision of the manuscript for important intellectual content: JIS and MSS. Statistical analysis: JIS and MSS. Obtained funding: None. Administrative technical or material support: None. Study supervision: None. Financial disclosures: None.

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Correspondence to Jonathan I. Silverberg.

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Shaheen, M.S., Silverberg, J.I. Association of inflammatory skin diseases with venous thromboembolism in US adults. Arch Dermatol Res 313, 281–289 (2021). https://doi.org/10.1007/s00403-020-02099-6

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  • DOI: https://doi.org/10.1007/s00403-020-02099-6

Keywords

  • Eczema
  • Atopic dermatitis
  • Psoriasis
  • Hidradenitis
  • Pemphigus
  • Pemphigoid
  • Blood clot
  • Thrombosis