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Article ; Online: Response to: "Methotrexate Use and Liver Outcomes in Psoriasis and Rheumatoid Arthritis Patients: A Commentary on 'Risk of liver disease in patients with psoriasis, psoriatic arthritis and rheumatoid arthritis receiving methotrexate: A population-based study'".

Gelfand, Joel M / Syed, Maha N

Journal of the American Academy of Dermatology

2021 Volume 85, Issue 6, Page(s) e401

MeSH term(s)	Arthritis, Psoriatic/drug therapy ; Arthritis, Psoriatic/epidemiology ; Arthritis, Rheumatoid/drug therapy ; Arthritis, Rheumatoid/epidemiology ; Humans ; Liver Diseases ; Methotrexate/adverse effects ; Psoriasis/drug therapy ; Psoriasis/epidemiology
Chemical Substances	Methotrexate (YL5FZ2Y5U1)
Language	English
Publishing date	2021-08-14
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	603641-7
ISSN	1097-6787 ; 0190-9622
ISSN (online)	1097-6787
ISSN	0190-9622
DOI	10.1016/j.jaad.2021.07.068
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Article ; Online: Commentary.

Shin, Daniel B / Syed, Maha N / Gelfand, Joel M

Journal of the American Academy of Dermatology

2020 Volume 84, Issue 3, Page(s) e161–e162

Keywords	covid19
Language	English
Publishing date	2020-10-08
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	603641-7
ISSN	1097-6787 ; 0190-9622
ISSN (online)	1097-6787
ISSN	0190-9622
DOI	10.1016/j.jaad.2020.10.001
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Article ; Online: Atopic dermatitis and risk for headache disorders and migraines: a population-based cohort study in children and adults from the UK.

Fuxench, Zelma C Chiesa / Wan, Joy / Wang, Sonia / Syed, Maha N / Shin, Daniel B / Abuabara, Katrina / Gelfand, Joel M

The British journal of dermatology

2023 Volume 190, Issue 1, Page(s) 120–123

MeSH term(s)	Child ; Adult ; Humans ; Dermatitis, Atopic/complications ; Dermatitis, Atopic/epidemiology ; Cohort Studies ; Migraine Disorders/complications ; Migraine Disorders/epidemiology ; Headache Disorders ; United Kingdom/epidemiology
Language	English
Publishing date	2023-09-05
Publishing country	England
Document type	Journal Article
ZDB-ID	80076-4
ISSN	1365-2133 ; 0007-0963
ISSN (online)	1365-2133
ISSN	0007-0963
DOI	10.1093/bjd/ljad325
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Article ; Online: Neuropsychiatric disorders in adults with atopic dermatitis: A population-based cohort study.

Wan, Joy / Wang, Sonia / Shin, Daniel B / Syed, Maha N / Abuabara, Katrina / Lemeshow, Adina R / Gelfand, Joel M

Journal of the European Academy of Dermatology and Venereology : JEADV

2023 Volume 38, Issue 3, Page(s) 543–548

Abstract: Background: Atopic dermatitis (AD) may be associated with an increased burden of neuropsychiatric outcomes such as anxiety and depression, but longitudinal data on the impact of AD severity is lacking, and a comprehensive assessment of neuropsychiatric ... ...

Abstract	Background: Atopic dermatitis (AD) may be associated with an increased burden of neuropsychiatric outcomes such as anxiety and depression, but longitudinal data on the impact of AD severity is lacking, and a comprehensive assessment of neuropsychiatric disease in adults with AD is needed. Objectives: Determine risk of incident neuropsychiatric disease among adults with AD by severity. Methods: A cohort study using electronic health records data from UK general practices from 1994 to 2015. Adults (≥18 years) with AD were matched on age, practice and index date to patients without AD. AD severity was categorized using treatments and dermatology referrals. Outcomes were incident anxiety, depression, bipolar disorder, schizophrenia, attention-deficit/hyperactivity disorder (ADHD), autism, obsessive-compulsive disorder (OCD), suicidality and completed suicide. Results: Comparing 625,083 adults with AD to 2,678,888 adults without AD, AD was associated with higher risk of anxiety [HR 1.14 (1.13-1.15)], depression [1.14 (1.13-1.15)] and OCD [1.48 (1.38-1.58)] across all severities. Mild or moderate AD was also associated with higher risk of autism, ADHD, bipolar disorder and suicidality. Conclusions: Atopic dermatitis is associated with a higher risk of multiple neuropsychiatric conditions, but these risks differ by specific condition and AD severity. Clinicians should inquire about mental health in patients with AD.
MeSH term(s)	Adult ; Humans ; Dermatitis, Atopic/complications ; Dermatitis, Atopic/epidemiology ; Dermatitis, Atopic/psychology ; Cohort Studies ; Anxiety ; Attention Deficit Disorder with Hyperactivity/complications ; Attention Deficit Disorder with Hyperactivity/epidemiology ; Suicidal Ideation
Language	English
Publishing date	2023-09-26
Publishing country	England
Document type	Journal Article
ZDB-ID	1128828-0
ISSN	1468-3083 ; 0926-9959
ISSN (online)	1468-3083
ISSN	0926-9959
DOI	10.1111/jdv.19518
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Zs.A 3492: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 413: Show issues

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Article ; Online: Atopic dermatitis and risk of major neuropsychiatric disorders in children: A population-based cohort study.

Wan, Joy / Shin, Daniel B / Syed, Maha N / Abuabara, Katrina / Lemeshow, Adina R / Gelfand, Joel M

Journal of the European Academy of Dermatology and Venereology : JEADV

2022 Volume 37, Issue 1, Page(s) 114–122

Abstract: Background: Paediatric atopic dermatitis (AD) has been linked to neuropsychiatric comorbidities such as depression, anxiety and attention-deficit/hyperactivity disorder (ADHD). However, longitudinal data are limited, and the effect of AD severity on ... ...

Abstract	Background: Paediatric atopic dermatitis (AD) has been linked to neuropsychiatric comorbidities such as depression, anxiety and attention-deficit/hyperactivity disorder (ADHD). However, longitudinal data are limited, and the effect of AD severity on neuropsychiatric outcomes requires further characterization. Objectives: To determine the risk of several major neuropsychiatric conditions in children with AD. Methods: We analysed UK health records data in a population-based cohort study. Each patient <18 years old with AD was matched to up to five unaffected patients on age, practice and index date. Treatments served as proxies for AD severity, which was analysed in a time-updated manner. Outcomes were incident anxiety, depression, bipolar disorder, schizophrenia, ADHD, autism, obsessive-compulsive disorder (OCD), suicidal ideation or attempt, and completed suicide. Results: A total of 409,431 children with AD (93.2% mild, 5.5% moderate, 1.3% severe) were compared to 1,809,029 children without AD. In Cox regression models adjusted for age, sex, socioeconomic status and other atopic comorbidities, no statistically significant relationships were observed between AD and incident anxiety (HR 1.01, 95% CI 0.99-1.03), ADHD (1.02, 0.97-1.06), autism (1.02, 0.98-1.06), bipolar disorder (1.08, 0.85-1.36), suicidal ideation/attempt (0.98, 0.95-1.01) or completed suicide (0.85, 0.64-1.14). Children with AD were less likely to develop depression (0.93, 0.91-0.95) or schizophrenia (0.72, 0.54-0.95) but more likely to develop OCD (1.26, 1.16-1.37). However, there was substantial variation by AD severity and age in both the direction and magnitude of effect for many of the neuropsychiatric conditions examined. Conclusions: The was no substantial impact of AD on the overall risk of many neuropsychiatric conditions in children, but disease severity and age may be important modifying factors. Additional research is needed to further dissect the complex relationship between paediatric AD and neuropsychiatric comorbidities.
MeSH term(s)	Child ; Humans ; Adolescent ; Dermatitis, Atopic/complications ; Dermatitis, Atopic/epidemiology ; Dermatitis, Atopic/psychology ; Cohort Studies ; Risk Factors ; Suicidal Ideation ; Attention Deficit Disorder with Hyperactivity/complications ; Attention Deficit Disorder with Hyperactivity/epidemiology
Language	English
Publishing date	2022-09-08
Publishing country	England
Document type	Journal Article
ZDB-ID	1128828-0
ISSN	1468-3083 ; 0926-9959
ISSN (online)	1468-3083
ISSN	0926-9959
DOI	10.1111/jdv.18564
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Zs.A 3492: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 413: Show issues

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Article ; Online: Incident Asthma, Asthma Exacerbations, and Asthma-Related Hospitalizations in Patients With Atopic Dermatitis.

Wan, Joy / Wang, Sonia / Shin, Daniel B / Syed, Maha N / Abuabara, Katrina / Lemeshow, Adina R / Gelfand, Joel M

The journal of allergy and clinical immunology. In practice

2023 Volume 12, Issue 2, Page(s) 421–430.e1

Abstract: Background: Atopic dermatitis (AD) is thought to induce asthma via the "atopic march," but the effects of AD on incident asthma and asthma severity have not been fully characterized.: Objective: To determine risk of asthma, asthma exacerbations, and ... ...

Abstract	Background: Atopic dermatitis (AD) is thought to induce asthma via the "atopic march," but the effects of AD on incident asthma and asthma severity have not been fully characterized. Objective: To determine risk of asthma, asthma exacerbations, and asthma-related hospitalizations among patients fwith AD. Methods: A cohort study was conducted using electronic health records data from UK general practices from 1994 to 2015. Children (<18 years old) and adults (≥18 years) with AD were matched on age, practice, and index date to patients without AD. AD severity was categorized using treatments and dermatologist referrals. Outcomes were incident asthma among all patients and asthma exacerbation or hospitalization among patients with asthma. Results: On comparing 409,341 children with AD (93.2% mild, 5.5% moderate, 1.3% severe) with 1,809,029 unaffected children, those with AD were found to be associated with a 2-fold greater risk of asthma compared with those without AD (hazard ratio, 1.96; 95% CI, 1.93-1.98). On comparing 625,083 adults with AD (65.7% mild, 31.4% moderate, and 2.9% severe) with 2,678,888 unaffected adults, AD was found to be associated with a 38% higher risk of asthma (hazard ratio, 1.38; 95% CI, 1.36-1.40). Asthmatic patients with AD also had a 21% to 63% greater risk of asthma exacerbations and a 20% to 64% greater risk of asthma-related hospitalizations compared with asthmatic patients without AD. Risk of asthma, asthma exacerbation, or asthma-related hospitalization increased with AD severity in a dose-dependent manner in both the pediatric and adult cohorts. Conclusions: AD, especially in children and when more severe, is associated with greater risk of asthma as well as greater risk of asthma exacerbations and hospitalizations among asthmatic patients.
MeSH term(s)	Adult ; Humans ; Child ; Adolescent ; Dermatitis, Atopic/epidemiology ; Dermatitis, Atopic/complications ; Cohort Studies ; Asthma/epidemiology ; Asthma/complications ; Hospitalization ; Severity of Illness Index
Language	English
Publishing date	2023-11-14
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	2843237-X
ISSN	2213-2201 ; 2213-2198
ISSN (online)	2213-2201
ISSN	2213-2198
DOI	10.1016/j.jaip.2023.11.009
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Zs.A 7086: Show issues

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Article ; Online: Incidence of Cardiovascular Disease and Venous Thromboembolism in Patients With Atopic Dermatitis.

Wan, Joy / Fuxench, Zelma C Chiesa / Wang, Sonia / Syed, Maha N / Shin, Daniel B / Abuabara, Katrina / Lemeshow, Adina R / Gelfand, Joel M

The journal of allergy and clinical immunology. In practice

2023 Volume 11, Issue 10, Page(s) 3123–3132.e3

Abstract: Background: Atopic dermatitis (AD) may increase risk for atherothrombotic and cardiovascular (CV) disease.: Objective: Determine CV disease and venous thromboembolism risk among patients with AD.: Methods: Cohort study using electronic health data ...

Abstract	Background: Atopic dermatitis (AD) may increase risk for atherothrombotic and cardiovascular (CV) disease. Objective: Determine CV disease and venous thromboembolism risk among patients with AD. Methods: Cohort study using electronic health data from U.K. general practices in 1994 to 2015. Children (<18 y) and adults (≥18 y) with AD were matched to patients without AD on age, same practice, and encounter date. Treatments and specialist referrals served as proxies of AD severity. Outcomes were incident myocardial infarction, cerebrovascular accident (CVA), diabetes, hypertension, dyslipidemia, deep vein thrombosis (DVT), and pulmonary embolism. Cox regression analysis was used to compare outcomes in AD versus non-AD patients. Results: Comparing 409,341 children with AD (93.2% mild, 5.5% moderate, and 1.3% severe) to 1,809,029 unaffected children, AD was associated with higher risk of DVT (hazard ratio [HR] 1.23; 95% confidence interval [95% CI] 1.02-1.48) and severe AD was associated with higher risk of CVA (HR 2.43; 95% CI 1.13-5.22) and diabetes (HR 1.46; 95% CI 1.06-2.01). Comparing 625,083 adults with AD (65.7% mild, 31.4% moderate, and 2.9% severe) to 2,678,888 unaffected adults, AD, especially when severe, was associated with higher risk of DVT (HR 1.14; 95% CI 1.11-1.18; and HR 1.64; 95% CI 1.49-1.82, respectively) and small but increased risks of CVA, diabetes, and dyslipidemia. Adults with severe AD had higher risk of myocardial infarction (HR 1.27; 95% CI 1.15-1.39), CVA (HR 1.21; 95% CI 1.13-1.30), diabetes (HR 1.15; 95% CI 1.09-1.22), dyslipidemia (HR 1.11; 95% CI 1.06-1.17), and pulmonary embolism (HR 1.39; 95% CI 1.21-1.60) compared with adults without AD. Conclusions: Atopic dermatitis, particularly when severe, is associated with small but increased risks of CV risk factors and events and significantly increased risk of venous thromboembolism.
Language	English
Publishing date	2023-08-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2843237-X
ISSN	2213-2201 ; 2213-2198
ISSN (online)	2213-2201
ISSN	2213-2198
DOI	10.1016/j.jaip.2023.08.007
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Article ; Online: Malignancy risk in patients with atopic dermatitis: a population-based cohort study.

Wan, Joy / Shin, Daniel B / Syed, Maha N / Abuabara, Katrina / Lemeshow, Adina R / Fuxench, Zelma C Chiesa / Gelfand, Joel M

The British journal of dermatology

2023 Volume 189, Issue 1, Page(s) 53–61

Abstract: Background: Atopic dermatitis (AD) is associated with immunological dysfunction, which may influence cancer development. Previous studies of AD and cancer demonstrate inconsistent results and few of these studies examined children or AD severity and ... ...

Abstract	Background: Atopic dermatitis (AD) is associated with immunological dysfunction, which may influence cancer development. Previous studies of AD and cancer demonstrate inconsistent results and few of these studies examined children or AD severity and treatment. Objectives: To determine malignancy risk among children and adults with AD. Methods: We conducted a cohort study using electronic health records data from UK general practices in The Health Improvement Network between 1994 and 2015. Children (< 18 years old) and adults (≥ 18 years old) with AD were matched on age, practice and index date to patients without AD. AD was categorized as mild, moderate or severe using treatments and dermatology referrals as proxies. The primary outcome was any incident malignancy, including in situ malignancy, identified using diagnosis codes and categorized into haematological, skin and solid organ malignancies. Secondary outcomes included specific malignancies: leukaemia, lymphoma, melanoma, nonmelanoma skin cancer (NMSC) and common solid-organ cancers. Results: Among 409 431 children with AD (93.2% mild, 5.5% moderate, 1.3% severe) and 1 809 029 children without AD who had median follow-up of 5-7 years, the incidence rates of malignancy were 1.9-3.4 and 2.0 per 10 000 person-years (PY), respectively. The adjusted risk of malignancy overall did not differ with respect to AD [hazard ratio (HR) 1.02 (95% confidence interval 0.92-1.12)]. Severe AD was associated with increased lymphoma risk [HR 3.18 (1.41-7.16), excluding cutaneous T-cell lymphoma (CTCL)], and mild AD was associated with increased NMSC risk [1.55 (1.06-2.27)]. Among 625 083 adults with AD (65.7% mild, 31.4% moderate, 2.9% severe) and 2 678 888 adults without AD who had median follow-up of 5 years, incidence rates of malignancy were 97.4-125.3 per 10 000 PY and 103.7 per 10 000 PY, respectively. The adjusted risk of any malignancy did not differ with respect to AD [HR 1.00 (0.99-1.02)]. However, adults with severe AD had a twofold higher risk of non-CTCL lymphoma. AD was also associated with slightly higher skin cancer risk [HR 1.06 (1.04-1.08)] and slightly lower solid cancer risk [0.97 (0.96-0.98)] but results varied by specific cancers and AD severity. Conclusions: Epidemiological evidence does not support a strong overall malignancy risk in AD but lymphoma risk may be increased with severe AD.
MeSH term(s)	Adult ; Child ; Humans ; Adolescent ; Dermatitis, Atopic/epidemiology ; Cohort Studies ; Lymphoma ; Melanoma ; Skin Neoplasms/epidemiology ; Skin Neoplasms/etiology
Language	English
Publishing date	2023-07-07
Publishing country	England
Document type	Journal Article
ZDB-ID	80076-4
ISSN	1365-2133 ; 0007-0963
ISSN (online)	1365-2133
ISSN	0007-0963
DOI	10.1093/bjd/ljad072
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Article ; Online: Risk of Inflammatory Bowel Disease in Patients With Atopic Dermatitis.

Chiesa Fuxench, Zelma C / Wan, Joy / Wang, Sonia / Syed, Maha N / Shin, Daniel B / Abuabara, Katrina / Gelfand, Joel M

JAMA dermatology

2023 Volume 159, Issue 10, Page(s) 1085–1092

Abstract: Importance: Data on the association between atopic dermatitis (AD) and inflammatory bowel disease (IBD) are inconsistent. Few studies have examined the association of AD or AD severity with risk of ulcerative colitis (UC) and Crohn disease (CD) ... ...

Abstract	Importance: Data on the association between atopic dermatitis (AD) and inflammatory bowel disease (IBD) are inconsistent. Few studies have examined the association of AD or AD severity with risk of ulcerative colitis (UC) and Crohn disease (CD) separately. Objectives: To examine the risk of new-onset IBD, UC, and CD in children and adults with AD. Design, setting, and participants: This population-based cohort study assessed patients with AD matched with up to 5 controls on age, practice, and index date. Treatment exposure was used as a proxy for AD severity. Data were retrieved from The Health Improvement Network, a UK electronic medical record database, for January 1, 1994, to February 28, 2015. Data analysis was performed from January 8, 2020, to June 30, 2023. Main outcomes and measures: Outcomes of interest were incident IBD, UC, and CD. Logistic regression was used to examine the risk for each outcome in children and adults with AD compared with controls. Results: A total of 1 809 029 pediatric controls were matched to 409 431 children with AD (93.2% mild, 5.5% moderate, and 1.3% severe). The pediatric cohort ranged in median age from 4 to 5 years (overall range, 1-10 years), was predominantly male (936 750 [51.8%] controls, 196 996 [51.6%] with mild AD, 11 379 [50.7%] with moderate AD, and 2985 [56.1%] with severe AD), and with similar socioeconomic status. A total of 2 678 888 adult controls were matched to 625 083 adults with AD (65.7% mild, 31.4% moderate, and 2.9% severe). The adult cohort ranged in median age from 45 to 50 years (overall range, 30-68 years) and was predominantly female (1 445 589 [54.0%] controls, 256 071 [62.3%] with mild AD, 109 404 [55.8%] with moderate AD, and 10 736 [59.3%] with severe AD). In fully adjusted models, children with AD had a 44% increased risk of IBD (hazard ratio [HR], 1.44; 95% CI, 1.31-1.58) and a 74% increased risk of CD (HR, 1.74; 95% CI, 1.54-1.97), which increased with worsening AD; however, they did not have increased risk of UC (HR, 1.09; 95% CI, 0.94-1.27) except for those with severe AD (HR, 1.65; 95% CI, 1.02-2.67). Adults with AD had a 34% (HR, 1.34; 95% CI, 1.27-1.40) increased risk of IBD, a 36% (HR, 1.36; 95% CI, 1.26-1.47) increased risk of CB, and a 32% (HR, 1.32; 95% CI, 1.24-1.41) increased risk of UC, with risk increasing with worsening AD. Conclusion and relevance: In this cohort study, children and adults with AD had an increased risk of IBD, with risk varying by age, AD severity, and IBD subtype. These findings provide new insights into the association between AD and IBD. Clinicians should be aware of these risks, particularly when selecting systemic treatments for AD in patients who may have coincident gastrointestinal symptoms.
MeSH term(s)	Adult ; Humans ; Male ; Female ; Child ; Infant ; Child, Preschool ; Middle Aged ; Aged ; Cohort Studies ; Dermatitis, Atopic/epidemiology ; Dermatitis, Atopic/complications ; Inflammatory Bowel Diseases/complications ; Inflammatory Bowel Diseases/epidemiology ; Colitis, Ulcerative/complications ; Colitis, Ulcerative/epidemiology ; Colitis, Ulcerative/diagnosis ; Crohn Disease/complications ; Crohn Disease/epidemiology ; Crohn Disease/diagnosis ; Risk Factors
Language	English
Publishing date	2023-08-30
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2701761-8
ISSN	2168-6084 ; 2168-6068
ISSN (online)	2168-6084
ISSN	2168-6068
DOI	10.1001/jamadermatol.2023.2875
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Article: Machine Learning Applications in the Evaluation and Management of Psoriasis: A Systematic Review.

Yu, Kimberley / Syed, Maha N / Bernardis, Elena / Gelfand, Joel M

Journal of psoriasis and psoriatic arthritis

2020 Volume 5, Issue 4, Page(s) 147–159

Abstract: Background: Machine learning (ML), a subset of artificial intelligence (AI) that aims to teach machines to automatically learn tasks by inferring patterns from data, holds significant promise to aid psoriasis care. Applications include evaluation of ... ...

Abstract	Background: Machine learning (ML), a subset of artificial intelligence (AI) that aims to teach machines to automatically learn tasks by inferring patterns from data, holds significant promise to aid psoriasis care. Applications include evaluation of skin images for screening and diagnosis as well as clinical management including treatment and complication prediction. Objective: To summarize literature on ML applications to psoriasis evaluation and management and to discuss challenges and opportunities for future advances. Methods: We searched MEDLINE, Google Scholar, ACM Digital Library, and IEEE Xplore for peer-reviewed publications published in English through December 1, 2019. Our search queries identified publications with any of the 10 computing-related keywords and "psoriasis" in the title and/or abstract. Results: Thirty-three studies were identified. Articles were organized by topic and synthesized as evaluation- or management-focused articles covering 5 content categories: (A) Evaluation using skin images: (1) identification and differential diagnosis of psoriasis lesions, (2) lesion segmentation, and (3) lesion severity and area scoring; (B) clinical management: (1) prediction of complications and (2) treatment. Conclusion: Machine learning has significant potential to aid psoriasis evaluation and management. Current topics popular in ML research on psoriasis are the evaluation of medical images, prediction of complications, and treatment discovery. For patients to derive the greatest benefit from ML advancements, it is helpful for dermatologists to have an understanding of ML and how it can effectively aid their assessments and decision-making.
Language	English
Publishing date	2020-08-31
Publishing country	United States
Document type	Journal Article
ISSN	2475-5303
ISSN	2475-5303
DOI	10.1177/2475530320950267
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