Atopic Dermatitis Linked to Higher Autoimmune Disease Risk
Patients with atopic dermatitis (AD) face a significantly increased risk of developing autoimmune diseases, according to a new systematic review and meta-analysis published in Frontiers in Immunology. The study combined evidence from 26 epidemiologic studies spanning 2014–2024 and included data from more than 16 million individuals worldwide. The protocol was prospectively registered on PROSPERO.
Study Findings
The meta-analysis synthesized data from 26 studies—19 cohort studies, 2 case-control studies, and 5 cross-sectional investigations—encompassing 1,629,723 patients with AD and 15,106,889 matched controls. Using pooled analysis, researchers found a significant association between AD and autoimmune diseases with a hazard ratio (HR) of 1.49 (95% CI, 1.31–1.70; P < .001).
Included autoimmune conditions ranged broadly across organ systems: celiac disease, systemic lupus erythematosus, Sjögren syndrome, ankylosing spondylitis, alopecia areata, rheumatoid arthritis, vitiligo, thyroid dysfunction, and ulcerative colitis. Both adults and children with AD demonstrated elevated risk profiles.
The analysis also noted sex-based differences, reporting that women with AD were more likely to develop autoimmune complications compared with men. Although the dataset was extensive, the authors acknowledged that the total number of included participants remained limited relative to disease complexity and heterogeneity, underscoring the need for additional high-quality longitudinal research.
Clinical Implications
These findings highlight important considerations for clinicians managing patients with atopic dermatitis. The observed elevated risk across multiple autoimmune conditions suggests that AD may share overlapping immunologic pathways with systemic autoimmunity, aligning with current understanding of dysregulated type 2 and broader immune activation in AD.
Practically, this association may warrant heightened clinical vigilance, particularly for multisystem symptoms in patients with moderate-to-severe AD or those with early-onset disease. Screening for autoimmune symptoms or comorbidities may be valuable in targeted populations, especially women, who demonstrated higher susceptibility. Early identification could support timelier referral to subspecialists, coordinated care management, and optimized treatment planning.
The findings also emphasize the importance of holistic care approaches that extend beyond dermatologic symptom control. As systemic biologics and small-molecule therapies become more widely used in AD, clinicians may increasingly integrate comorbidity risk assessments to individualize treatment and follow-up strategies.
Expert Commentary
“Our study indicates a clear association between atopic dermatitis and autoimmune diseases, both in adults and children,” said H. Wang, PhD, lead author of the systematic review and meta-analysis. Wang added that “women were more likely to have autoimmune disease complications than men,” noting that the relationship warrants further investigation due to the limited number of participants and study-level heterogeneity.
This large-scale synthesized analysis strengthens evidence that atopic dermatitis is associated with a significantly increased risk of autoimmune diseases across age groups. Further prospective studies are needed to clarify mechanisms, quantify risk in diverse populations, and guide evidence-based screening and management strategies.
Reference
Wang H, Chen M, Wang T, et al. Atopic dermatitis and risk of autoimmune diseases: a systematic review and meta-analysis. Front Immunol. 2025;16(6). DOI: 10.1186/s13223-021-00597-4
