Atopic dermatitis is not associated with actinic keratosis: cross-sectional results from the Rotterdam study

Background Epidermal barrier impairment and an altered immune system in atopic dermatitis (AD) may predispose to ultraviolet-induced DNA damage. Objectives To study the association between AD and actinic keratosis (AK) in a population-based cross-sectional study. Methods AD was defined by modified criteria of the U.K. working party's diagnostic criteria. AKs were diagnosed by physicians during a full-body skin examination, and keratinocyte cancers were identified via linkage to the national pathology database. The results were analysed in adjusted multivariable and multinomial models. Results A lower proportion of subjects with AD had AKs than those without AD: 16% vs. 24%, P = 0.002; unadjusted odds ratio (OR) 0.60, 95% confidence interval (CI) 0.42-0.83; adjusted OR 0.74, 95% CI 0.51-1.05; fully adjusted OR 0.69, 95% CI 0.47-1.07. In a multinomial model patients with AD were less likely to have >= 10 AKs (adjusted OR 0.28, 95% CI 0.09-0.90). No effect of AD on basal cell carcinoma or squamous cell carcinoma was found: adjusted OR 0.71, 95% CI 0.41-1.24 and adjusted OR 1.54, 95% CI 0.66-3.62, respectively. Conclusions AD in community-dwelling patients is not associated with AK.