Clinical Characteristics of Patients Presenting with Moderate-to-Severe Atopic Dermatitis and Concomitant Inflammatory Bowel Diseases: a Multicenter Retrospective Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: Atopic dermatitis (AD) and inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are chronic immune-mediated disorders with overlapping immunopathogenic mechanisms. Limited research has investigated clinical features of AD and concomitant IBD. OBJECTIVES: This study aimed to evaluate the clinical presentation of adult patients with concomitant moderate-to-severe AD and IBD. METHODS: Adult patients with moderate-to-severe AD and confirmed IBD were identified across 12 hospital-based dermatology centers between 2022 and 2024 by using electronic records. RESULTS: Thirty-eight out of 4,236 (0.9%) patients with moderate-to-severe AD had verified IBD (19 CD and 19 UC), with a prevalence higher than that expected in the general Italian population (0.9% vs 0.41%). The mean age at AD diagnosis was 25 years, with AD preceding IBD diagnosis with a median interval of 10 years in 71% of cases. At the time of the study, 40% of CD patients and 63% of UC patients were in clinical remission. AD clinical presentation in patients with IBD was typical, with 68% of patients presenting with flexural phenotype, and associated with personal (34%) or family (40%) history of atopy. CONCLUSIONS: IBD is not frequent in AD patients, but the prevalence seems to be higher compared to the general population. AD occurring with IBD had a typical clinical presentation. Interestingly, occurrence of AD preceded IBD onset in most patients, putting dermatologists in the position to make early IBD diagnosis. However, no direct causal relationship can be drawn from these findings. Larger, controlled prospective studies are needed to clarify the relationship between AD and IBD.
Institutions: Ospedale San Bortolo, Federico II University Hospital, University of Naples Federico II, University of Verona, University of Bari Aldo Moro, Azienda Sanitaria Unità Locale di Reggio Emilia, University of Turin, University of Brescia, Magna Graecia University, University of L'Aquila, Università Cattolica del Sacro Cuore, Agostino Gemelli University Polyclinic, Istituti di Ricovero e Cura a Carattere Scientifico, IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola, IRCCS Humanitas Research Hospital
Language: English
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7171973986