Bipolar disorder among individuals with atopic dermatitis: A case-control study in the All of Us Research Program.

BACKGROUND: Atopic dermatitis (AD) has been associated with psychiatric comorbidities. OBJECTIVES: To characterize the association between AD and bipolar disorder (BPD) with a case-control study of the NIH All of Us Research Program. METHODS: Utilizing Systemized Nomenclature of Medicine diagnostic codes, we identified cases of AD. Four age, sex, and race/ethnicity matched controls were found for each case using propensity score matching. After controlling for age, sex, race/ethnicity, income, smoking status, and depression, the relationship between AD and BPD was evaluated using logistic regression. RESULTS: We identified 13,431 AD cases with 53,724 matched controls. Participants with AD were more likely than controls to have BPD (7.8% vs. 4.6%, P<.001). After adjusting for demographics and comorbidities, we observed a significant association (OR 1.49, 95%CI 1.37-1.62, P<.001). CONCLUSION: Compared to individuals without AD, individuals with AD have 1.49-fold increased odds of having BPD. Further investigation is needed to further understand this association.

Migraine among adults with atopic dermatitis: a cross-sectional study in the All of Us research programme.

Atopic dermatitis (AD) has been previously associated with migraine headaches in paediatric and adolescent populations, though there is less evidence for this relationship among adults. In this cross-sectional study, we investigated the association between AD and migraine among a cohort of US adults in the All of Us research programme. After controlling for common comorbidities, we found that adults with AD were 89% more likely to have a diagnosis of migraine (OR = 1·89, P < 0·001).

Psoriasis associated with asthma and allergic rhinitis: a US-based cross-sectional study using the All of US Research Program.

Psoriasis is a common chronic inflammatory disease with multiple known comorbidities. Increasing evidence suggests some mechanistic overlap in the immunopathogenesis of psoriasis and some cases of asthma and allergic rhinitis (AR), but the potential association between psoriasis and asthma and AR has not been thoroughly investigated. The study aimed to investigate the association between psoriasis and asthma and AR. We used data from the NIH All of US Research Program, a nationwide longitudinal cohort of US adults, collected from 2018 to present. The source population comprised a demographically and socioeconomically diverse cohort of over 300,000 Americans. We used multivariable logistic regression models to examine the association between psoriasis and asthma and AR, after adjusting for sociodemographic variables, body mass index, and smoking status. In total, 235,551 participants (mean [SD] age, 54.7 [16.6] years; 59.3% female), including 5165 individuals with psoriasis and 230,386 individuals without psoriasis, were included in our analysis. Participants with psoriasis had significantly higher prevalence of asthma (26.1% vs. 12.9%; P < 0.001) and AR (31.8% vs. 13.4%; P < 0.001) compared to participants without psoriasis. Psoriasis was significantly associated with both asthma [adjusted odds ratio (aOR) 2.22; 95% confidence interval (CI) 2.08-2.37] and AR (aOR, 2.57; 95% CI 2.42-2.73). In subgroup analyses, associations remained stable in multivariable analyses after stratification by age, sex, and income. Psoriasis is associated with both asthma and AR in our sample of US adults. Further research is needed to explore potentially unifying inflammatory pathways among psoriasis, asthma, and AR.

Lichen planus is associated with depression and anxiety: a cross-sectional study in the All of Us research program.

Lichen planus (LP) can be accompanied by psychiatric comorbidities. Studies investigating the relationship between LP and clinically diagnosed anxiety and depression are limited. We aimed to determine the association of LP with anxiety and depression by conducting a cross-sectional population study of the All of Us research database, a National Institutes of Health cohort. Patients with LP were identified through electronic health record data using codes from the International Classification of Diseases and Systematized Nomenclature of Medicine. We used multivariable logistic regression to assess associations between LP and anxiety and depression before and after controlling for relevant covariates. Among 239,552 participants, 1083 individuals with LP were identified, with an average age of 67.20 years (standard deviation, 11.79) and a female predominance (74% female). The prevalence of depression and anxiety were higher among individuals with LP than in those without (41.6% vs 27.7%, p < 0.001; 43.5% vs 29.6%, p < 0.001). LP remained significantly associated with depression (OR, 1.36; 95% CI, 1.20-1.56, p < 0.001) and anxiety (OR, 1.48; 95% CI, 1.30-1.68, p < 0.001) after controlling for age, sex, hypothyroidism, autoimmune diseases, hypertension, type II diabetes mellitus, cardiovascular disease, and hepatitis C infection. In this cross-sectional study, LP was associated with an increase in odds of having depression and anxiety in multivariable analysis. Further study is needed to better understand the relationship between mental health outcomes and LP to address the needs of patients with LP more completely.

Acute Epstein-Barr virus infection resembling cutaneous T-cell lymphoma.

Primary, acute Epstein-Barr virus (EBV) infection is associated with a variety of cutaneous eruptions, including the viral exanthem of infectious mononucleosis and erythema multiforme. Latent, chronic EBV infection can rarely result in development of lymphoproliferative disorders with cutaneous manifestations; however, these disorders do not arise from primary infection. In this report, we present a case of primary, acute EBV infection presenting with histopathologic features closely mimicking aggressive cytotoxic cutaneous T-cell lymphoma.

Antibiotic Resistance Risk with Oral Tetracycline Treatment of Acne Vulgaris.

Almost 1 billion people worldwide have acne, and oral tetracyclines, including doxycycline and minocycline, are effective and frequently prescribed treatments for acne. However, there is growing concern for the development of antibiotic resistance with such widespread utilization by dermatologists. Additionally, tetracyclines are known to have various potential side effects, including gut dysbiosis, gastrointestinal upset, photosensitivity, dizziness, and vertigo. However, in 2018 a novel narrow-spectrum tetracycline, sarecycline, was Food and Drug Administration-approved to treat moderate-to-severe acne vulgaris in patients 9-years-old and above. Sarecycline was designed to target Cutibacterium acnes, the pathogenic bacterium in acne vulgaris, which may reduce the risk of resistance. This paper examines the growing concerns of antibiotic resistance due to oral tetracycline usage in the treatment of acne vulgaris, with a focus on the promising third-generation, narrow-spectrum tetracycline, sarecycline.

Vaccination Recommendations for Psoriasis and Atopic Dermatitis Patients on Biologic Therapy: A Practical Guide.

Novel biologic therapies have revolutionized the treatment of psoriasis and atopic dermatitis. Although they are generally safe, they are immunomodulatory and therefore unique considerations apply in regards to infections and vaccine administration. This review aims to provide a clear and practical guide for dermatologists or other healthcare providers to reference when caring for psoriasis or atopic dermatitis patients being treated with biologic therapies using currently available guidelines and clinical data. Vaccinations for approved biologics including TNFα, IL-12/23, IL-23, IL-17, and IL-4/13 inhibitors will be discussed, with a special note on current COVID-19 vaccination recommendations.