Eczema in adulthood should be considered a risk factor for fracture and bone or joint injury, according to the authors of a study published online ahead of print in JAMA Dermatology.

Fractures and bone or joint injuries can lead to loss of independence and an increased risk for early death among older adults in the United States, according to the Centers for Disease Control and Prevention. One study cited by the International Osteoporosis Foundation determined that the combined lifetime risk for hip, forearm, and vertebral fractures that will require clinical attention is approximately 40%, which is equivalent to the risk for cardiovascular disease (Kanis JA. Lancet. 2002;359[9321]:1929-1936).

In the recent analysis of 34,500 adults aged 18 to 85 years with a history of eczema in the previous 12 months, authors Nitin Garg, MD, and Jonathan I. Silverberg, MD, PhD, MPH, found that those with eczema were more likely to have bone fractures and bone or joint injuries.

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They determined that the prevalence of eczema was 7.2% and the prevalence of any injury-causing limitation was 2%. A limitation that caused a bone fracture and bone or joint injury was reported by 1.5% of study participants, and limitations that caused other types of injury occurred in 0.6%. 

The investigators found that the prevalence of limitations that caused fractures and bone or joint injuries increased with age, peaking at age 50 to 69 years but decreasing at age 70 years and older. They also found that adults with eczema and fatigue, daytime sleepiness, or insomnia had higher rates of fracture and bone or joint injury than did those with the same sleep issues but no diagnosis of eczema.

Adults with both eczema and psychiatric and behavioral disorders also had higher rates of fracture and bone or joint injury than did adults with eczema alone or psychiatric and behavioral disorders alone.

“Adult eczema is associated with an increased risk of injury, particularly fracture and bone or joint injury, which is only partially related to the presence of sleep symptoms and psychiatric and behavioral disorders,” concluded the author.

“Taken together, these data suggest that adult eczema is a previously unrecognized risk factor for fracture and other injury, emphasizing the importance of developing safer and more effective clinical interventions for itch and sleep problems in eczema, as well as preventive measures for injury risk reduction in eczema.”