Risk of skin disorders in patients with celiac disease: A population-based cohort study

Background: Although dermatitis herpetiformis is closely associated with celiac disease (CD), data on the relationship between CD and other dermatologic disorders have been mixed. We aimed to quantify the risk of skin disorders in patients after CD diagnosis in a population-based setting. Methods: Using data from all 28 pathology departments in Sweden from 1969 to 2016, we identified patients with CD. Each patient was matched by age, sex, calendar year, and geographic region to up to 5 population control individuals. We calculated the risk of any skin disease and specific skin diseases using Cox proportional hazards. Results: We identified 43,300 patients with CD and 198,532 matched control individuals. After a median follow-up time of 11.4 years, the incidences of skin disease in patients with CD and control individuals were 22.6 and 14.8 per 1000 person-years, respectively (hazard ratio [HR], 1.55; 95% confidence interval [CI], 1.51-1.58). Increased risks were present for eczema (HR, 1.67; 95% CI, 1.56-1.79), psoriasis (HR, 1.55; 95% CI, 1.43-1.68), urticaria (HR, 1.52; 95% CI, 1.42-1.64), vitiligo (HR, 1.90; 95% CI, 1.52-2.39), acne (HR, 1.39; 95% CI, 1.29-1.50), and alopecia areata (HR, 1.78; 95% CI, 1.43-2.20). Conclusions: Compared to the general population, patients with CD are at increased risk of multiple common skin disorders, a risk that persists in the long term.