title: Increased risk of stroke in contact dermatitis patients: A nationwide population-based retrospective cohort study.
abstract: Dermatologic diseases are not traditional risk factors of stroke, but recent studies show atopic dermatitis, psoriasis, and bullous skin disease may increase the risk of stroke and other cardiovascular diseases. No previous studies have focused on the association between contact dermatitis and stroke.We established a cohort comprised of 48,169 contact dermatitis patients newly diagnosed in 2000-2003 and 96,338 randomly selected subjects without the disorder, frequency matched by sex, age, and diagnosis year, as the comparison cohort. None of them had a history of stroke. Stroke incidence was assessed by the end of 2011 for both cohorts.The incidence stroke was 1.1-fold higher in the contact dermatitis cohort than in the comparison cohort (5.93 vs 5.37 per 1000 person-years, P < 0.01). The multivariable Cox method analyzed adjusted hazard ratios (aHRs) were 1.12 (95% confidence interval [CI], 1.05-1.19) for all stroke types and 1.12 (95% CI, 1.05-1.20) for ischemic stroke and 1.11 (95% CI, 0.94-1.30) for hemorrhagic stroke. The age-specific aHR of stroke for contact dermatitis cohort increased with age, from 1.14 (95% CI, 1.03-1.27) for 65 to 74 years; to 1.27 (95% CI, 1.15-1.42) for 75 years and older. The aHR of stroke were 1.16 (95% CI, 1.07-1.27) and 1.09 (95% CI, 1.00-1.18) for men and women, respectively.This study suggests that patients with contact dermatitis were at a modestly increased risk of stroke, significant for ischemic stroke but not for hemorrhagic stroke. Comorbidity, particularly hypertension, increased the hazard of stroke further.
authors.affiliation: Department of Neurology, Show-Chwan Memorial Hospital, Changhua, Taiwan, R.O.C Department of Medical Technology, Jen-The Junior College of Medicine, Nursing and Management, Miaoli, Taiwan, R.O.C Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan, R.O.C Department of Cardiology, Yuan Rung Hospital, Changhua, Taiwan, R.O.C Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, R.O.C Department of Neurology, Yuan Rung Hospital, Taiwan, R.O.C Department of Sport and Health Management, College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan, R.O.C Department of Nursing, College of Medicine & Nursing, HungKuang University, Taichung, Taiwan, R.O.C Department of Health Services Administration, College of Public Health, China Medical University, Taichung, Taiwan, R.O.C.
authors.forename: Wei-Lun
authors.initials: WL
authors.lastname: Chang
authors.forename: Min-Hsien
authors.initials: MH
authors.lastname: Hsu
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.forename: Po-Chi
authors.initials: PC
authors.lastname: Chan
authors.forename: Ko-Shih
authors.initials: KS
authors.lastname: Chang
authors.forename: Ching-Hsiao
authors.initials: CH
authors.lastname: Lee
authors.forename: Chung-Yi
authors.initials: CY
authors.lastname: Hsu
authors.forename: Min-Tein
authors.initials: MT
authors.lastname: Tsai
authors.forename: Chung-Hsin
authors.initials: CH
authors.lastname: Yeh
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003877:Dermatitis, Contact / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology