Acne Keloidalis Nuchae and the Metabolic Syndrome: A Population-Based Study.
Acne Keloid
/ epidemiology
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Comorbidity
Cross-Sectional Studies
Diabetes Mellitus, Type 2
/ diagnosis
Female
Humans
Hypertension
/ diagnosis
Israel
/ epidemiology
Male
Metabolic Syndrome
/ diagnosis
Middle Aged
Obesity
/ diagnosis
Prevalence
Retrospective Studies
Young Adult
Journal
American journal of clinical dermatology
ISSN: 1179-1888
Titre abrégé: Am J Clin Dermatol
Pays: New Zealand
ID NLM: 100895290
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
pubmed:
5
8
2020
medline:
25
5
2021
entrez:
5
8
2020
Statut:
ppublish
Résumé
The association between acne keloidalis nuchae (AKN) and the metabolic syndrome (MS) has been reported anecdotally. However, it is yet to be investigated in the setting of controlled studies, leaving this topic inconclusive in the current literature. The aim was to estimate the association between AKN and the MS and its components, utilizing one of the largest cohorts of patients with AKN. A retrospective, population-based, cross-sectional study was performed between 2005 and 2018. We utilized the database of Clalit Health Services, the largest public healthcare provider organization in Israel. The current study encompassed data collected from general community clinics, primary care, and referral centers, as well as from ambulatory and hospital care. A total of 2677 patients with AKN and 13,190 controls were included. The prevalence of the MS was greater in patients with AKN than in control subjects (16.1% vs. 6.6%, respectively; odds ratio [OR] 2.72; 95% confidence interval [CI] 2.40-3.08; P < 0.001). Obesity demonstrated the strongest association with AKN (OR 3.00; 95% CI 2.75-3.28), followed by type 2 diabetes mellitus (OR 2.47; 95% CI 2.20-2.77), hypertension (OR 1.82; 95% CI 1.63-2.05), and dyslipidemia (OR 1.60; 95% CI 1.46-1.75). Estimates were not altered significantly after controlling for putative confounding factors. A strong association was observed between AKN and the MS on the one hand, and with every one of its four components on the other. Physicians treating patients with AKN should be aware of this possible comorbidity. Patients with AKN should be carefully assessed for comorbid metabolic disorders.
Sections du résumé
BACKGROUND
BACKGROUND
The association between acne keloidalis nuchae (AKN) and the metabolic syndrome (MS) has been reported anecdotally. However, it is yet to be investigated in the setting of controlled studies, leaving this topic inconclusive in the current literature.
OBJECTIVE
OBJECTIVE
The aim was to estimate the association between AKN and the MS and its components, utilizing one of the largest cohorts of patients with AKN.
METHODS
METHODS
A retrospective, population-based, cross-sectional study was performed between 2005 and 2018. We utilized the database of Clalit Health Services, the largest public healthcare provider organization in Israel. The current study encompassed data collected from general community clinics, primary care, and referral centers, as well as from ambulatory and hospital care.
RESULTS
RESULTS
A total of 2677 patients with AKN and 13,190 controls were included. The prevalence of the MS was greater in patients with AKN than in control subjects (16.1% vs. 6.6%, respectively; odds ratio [OR] 2.72; 95% confidence interval [CI] 2.40-3.08; P < 0.001). Obesity demonstrated the strongest association with AKN (OR 3.00; 95% CI 2.75-3.28), followed by type 2 diabetes mellitus (OR 2.47; 95% CI 2.20-2.77), hypertension (OR 1.82; 95% CI 1.63-2.05), and dyslipidemia (OR 1.60; 95% CI 1.46-1.75). Estimates were not altered significantly after controlling for putative confounding factors.
CONCLUSIONS
CONCLUSIONS
A strong association was observed between AKN and the MS on the one hand, and with every one of its four components on the other. Physicians treating patients with AKN should be aware of this possible comorbidity. Patients with AKN should be carefully assessed for comorbid metabolic disorders.
Identifiants
pubmed: 32748304
doi: 10.1007/s40257-020-00541-z
pii: 10.1007/s40257-020-00541-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
733-739Références
Ogunbiyi A. Acne keloidalis nuchae: Prevalence, impact, and management challenges. Clin Cosmet Investig Dermatol. 2016;9:483–9.
doi: 10.2147/CCID.S99225
Azurdia RM, Graham RM, Weismann K, Guerin DM, Parslew R. Acne keloidalis in Caucasian patients on cyclosporin following organ transplantation. Br J Dermatol. 2000;43(2):465–7.
doi: 10.1046/j.1365-2133.2000.03694.x
Adegbidi H, Atadokpede F, do Ango-Padonou F, Yedomon H. Keloid acne of the neck: epidemiological studies over 10 years. Int J Dermatol. 2005;44(Suppl 1):49–50. https://doi.org/10.1111/j.1365-4632.2005.02815.x .
doi: 10.1111/j.1365-4632.2005.02815.x
pubmed: 16187963
Glenn MJ, Bennett RG, Kelly AP. Acne keloidalis nuchae: treatment with excision and second-intention healing. J Am Acad Dermatol. 1995;33(2 Pt 1):243–6. https://doi.org/10.1016/0190-9622(95)90242-2 .
doi: 10.1016/0190-9622(95)90242-2
pubmed: 7622651
Salami T, Omeife H, Samuel S. Prevalence of acne keloidalis nuchae in Nigerians. Int J Dermatol. 2007;46(5):482–4.
doi: 10.1111/j.1365-4632.2007.03069.x
Khumalo NP, Jessop S, Gumedze F, Ehrlich R. Hairdressing and the prevalence of scalp disease in African adults. Br J Dermatol. 2007;157(5):981–8. https://doi.org/10.1111/j.1365-2133.2007.08146.x .
doi: 10.1111/j.1365-2133.2007.08146.x
pubmed: 17725667
Ross EK, Tan E, Shapiro J. Update on primary cicatricial alopecias. J Am Acad Dermatol. 2005;53(1):1–40. https://doi.org/10.1016/j.jaad.2004.06.015 .
doi: 10.1016/j.jaad.2004.06.015
pubmed: 15965418
Sperling LC, Homoky C, Pratt L, Sau P. Acne keloidalis is a form of primary scarring alopecia. Arch Dermatol. 2000;136(4):479–84. https://doi.org/10.1001/archderm.136.4.479 .
doi: 10.1001/archderm.136.4.479
pubmed: 10768646
Shapero J, Shapero H. Acne keloidalis nuchae is scar and keloid formation secondary to mechanically induced folliculitis. J Cutan Med Surg. 2011;15(4):238–40. https://doi.org/10.2310/7750.2011.10057 .
doi: 10.2310/7750.2011.10057
pubmed: 21781632
Sperling LC, Solomon AR, Whiting DA. A new look at scarring alopecia. Arch Dermatol. 2000;136(2):235–42. https://doi.org/10.1001/archderm.136.2.235 .
doi: 10.1001/archderm.136.2.235
pubmed: 10677100
Rennert G, Peterburg Y. Prevalence of selected chronic diseases in Israel. Isr Med Assoc J [Internet]. 2001;3(6):404–8.
National Cholesterol Education Program (NCEP) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) final report. Circulation. 2002;106(25):3143–421.
Alberti KGMM, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: Diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation. Diabetes Med. 1998;15(7):539–53.
doi: 10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S
Shalom G, Dreiher J, Kridin K, Horev A, Khoury R, Battat E, et al. Atopic dermatitis and the metabolic syndrome: a cross-sectional study of 116 816 patients. J Eur Acad Dermatol Venereol. 2019;33(9):1762–7. https://doi.org/10.1111/jdv.15642 .
doi: 10.1111/jdv.15642
pubmed: 31045273
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis [Internet]. 1987;40(5):373–83. https://doi.org/10.1016/0021-9681(87)90171-8 .
doi: 10.1016/0021-9681(87)90171-8
Verma SB, Wollina U. Acne keloidalis nuchae: another cutaneous symptom of metabolic syndrome, truncal obesity, and impending/overt diabetes mellitus? Am J Clin Dermatol. 2010;11(6):433–6. https://doi.org/10.2165/11537000-000000000-00000 .
doi: 10.2165/11537000-000000000-00000
pubmed: 20507181
Haynes D, Topham C, Greiling T. Acne keloidalis nuchae and obstructive sleep apnoea: a retrospective case series. Clin Exp Dermatol. 2019;44(5):e214–5. https://doi.org/10.1111/ced.13985 .
doi: 10.1111/ced.13985
pubmed: 30980729
East-Innis ADC, Stylianou K, Paolino A, Ho JD. Acne keloidalis nuchae: risk factors and associated disorders—a retrospective study. Int J Dermatol. 2017;56(8):828–32. https://doi.org/10.1111/ijd.13678 .
doi: 10.1111/ijd.13678
pubmed: 28664654
Stefanadi EC, Dimitrakakis G, Antoniou C-K, Challoumas D, Punjabi N, Dimitrakaki IA, et al. Metabolic syndrome and the skin: a more than superficial association. Reviewing the association between skin diseases and metabolic syndrome and a clinical decision algorithm for high risk patients. Diabetol Metab Syndr [Internet]. 2018;10:9. https://doi.org/10.1186/s13098-018-0311-z (Published 2018 Feb 21).
doi: 10.1186/s13098-018-0311-z
Dunwell P, Rose A. Study of the skin disease spectrum occurring in an Afro-Caribbean population. Int J Dermatol. 2003;42(4):287–9. https://doi.org/10.1046/j.1365-4362.2003.01358.x .
doi: 10.1046/j.1365-4362.2003.01358.x
pubmed: 12694494
Yosipovitch G, DeVore A, Dawn A. Obesity and the skin: skin physiology and skin manifestations of obesity. J Am Acad Dermatol. 2007;56(6):901–20. https://doi.org/10.1016/j.jaad.2006.12.004 .
doi: 10.1016/j.jaad.2006.12.004
pubmed: 17504714
Byrd AL, Belkaid Y, Segre JA. The human skin microbiome. Nat Rev Microbiol. 2018;16(3):143–55. https://doi.org/10.1038/nrmicro.2017.157 .
doi: 10.1038/nrmicro.2017.157
pubmed: 29332945
Höfler M. The Bradford Hill considerations on causality: a counterfactual perspective. Emerg Themes Epidemiol [Internet]. 2005;2:11. https://doi.org/10.1186/1742-7622-2-11 (Published 2005 Nov 3).
doi: 10.1186/1742-7622-2-11
Birkenfeld S, Dreiher J, Weitzman D, Cohen AD. Coeliac disease associated with psoriasis. Br J Dermatol [Internet]. 2009;161:1331–4.
doi: 10.1111/j.1365-2133.2009.09398.x