Background
Infections can trigger worsening of atopic dermatitis (AD).
Objectives
To examine whether hospital‐managed paediatric AD is associated with increased risk of extracutaneous infections requiring hospitalization in childhood.
Methods
A nationwide‐based cohort study using Danish registries was done. Children aged < 18 years with a hospital diagnosis of AD and children without a hospital diagnosis of AD were sex‐ and age‐matched at date of AD diagnosis. Study outcomes were extracutaneous infections that led to hospitalization. AD severity was defined according to prescriptions for treatments.
Results
Of 19 415 children with AD [median follow‐up 7·4 years; interquartile range (IQR) 3·3–13.3] and 194 150 without AD (median follow‐up 7·7 years; IQR 3·6–13·5), 56% were boys and 50% were aged < 2 years. Children with AD had an increased rate of lower respiratory [LRTI; adjusted hazard ratio (aHR) 1·79, 95% confidence interval (CI) 1·65–1·94)], upper respiratory (URTI; aHR 1·59, 95% CI 1·34–1·88), urinary tract (UTI; aHR 1·34, 95% CI 1·16–1·54), musculoskeletal (MSSI; aHR 1·33, 95% CI 1·06–1·66) and gastrointestinal infections (GITIs; aHR 1·24, 95% CI 1·14–1·35) vs. children without AD. Associations did not clearly vary with AD severity. Absolute risk difference per 10 000 person‐years was 26·4 (95% CI 23·0–29·8) for LRTIs, 3·1 (95% CI 1·6–4·7) for URTIs, 3·6 (95% CI 1·8–5·4) for UTIs, 0·9 (95% CI 0·2–2·0) for MSSIs and 8·7 (95% CI 5·7–11·7) for GITIs.
Conclusions
Children with hospital‐managed AD have an increased risk of systemic infections that lead to hospitalization; absolute risk is generally low.