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Eczema associated with increased fracture risk, researchers warn

Patients who have eczema have a greater risk of fracture, according to a new study. 

A study of GP and hospital records from 3 million UK adults found that risk of any fracture was 13% greater in people with eczema than those without it.

Atopic eczema may need to be included in fracture prevention tools, said the authors of the study, which was published in the Journal of Allergy and Clinical Immunology.

The association was also linked with severity of disease, with more than double the risk of spinal fracture, 66% increased risk of pelvic fracture, and 50% increased risk of hip fracture in those with severe eczema. 

The link remained after taking oral steroid use into account, the researchers said.

While the overall risk is fairly low – an additional 164 people with a fracture per 100,000 people with atopic eczema – the population health implications are significant due to the common nature of the condition, the team concluded.

Study leader Professor Sinéad Langan from the London School of Hygiene & Tropical Medicine said more work was needed to fully understand what was behind the increased fracture risk.

She said: ‘There’s lots of reasons why people with eczema might have an increased fracture risk. For example, they might avoid exercise or are allergic to dairy or avoid certain foods. We haven’t delved into that in this study and that could be the next piece of work.

She added: ‘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.

‘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.’

Professor Langan added that current risk fracture tools, including the fracture risk assessment tool and QFracture, do not include atopic eczema and more work should be done to assess whether it should be included.

She added that it may help GPs to be aware of the risk in considering assessing a patient’s risk factor particularly if they are older and have long-term severe eczema.

The researchers also published a paper in the BMJ last year showing an increased risk of cardiovascular disease in patients with severe eczema.

 

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