Childhood atopic dermatitis and warts are associated with increased risk of infection: A US population-based study

Background Previous studies suggested that atopic dermatitis (AD) is associated with aberrant immune responses, which might predispose toward both cutaneous and extracutaneous infections. The goal of this study was to determine whether childhood AD is associated with increased risk of warts, extracutaneous infections, and other atopic diseases and how these disorders cosegregate. Methods The 2007 National Health Interview Survey from a nationally representative sample of 9417 children age 0 to 17 years was used. Results Children with AD and other atopic disease had higher odds of warts. In contrast, children with AD with or without other atopic disease had higher odds of extracutaneous infections, including strep throat, other sore throat, head or chest cold, influenza/pneumonia, sinus infections, recurrent ear infections, chickenpox, and urinary tract infections (P <.0001). Children with AD and other atopic disease had a higher number of infections than those with either disorder by itself (P <.0001). Warts were also associated with increased odds of all extracutaneous infections (P <.0001), except recurrent ear infections. Children with warts and AD had a higher number of infections than those with either disorder alone (P <.0001). Finally, children with AD and warts had higher odds of ever receiving a diagnosis of asthma, current asthma, asthma exacerbation in the past year, hay fever, and food allergy. Children with AD with warts had even higher odds of asthma, hay fever, and food allergies than those with AD and no warts. Conclusions The associations between childhood AD, atopic disease, warts, and extracutaneous infections suggest that barrier disruption, immune disruption, or both contribute to susceptibility to warts and extracutaneous infections in children.