People with Eczema Face 28% Higher Risk of Developing Shingles, Large UK Database Study Finds
核心洞察
A large UK primary care analysis of over 113 million individuals found that people with eczema (搜索) (atopic dermatitis (搜索)) have a 28% higher risk of developing shingles (搜索) after adjusting for age, sex, comorbidities, smoking, and alcohol use.
Shingles (搜索) risk increased with eczema (搜索) severity, and use of immunosuppressant medications had only a minimal effect on the elevated risk.
Researchers suggest an altered skin immune response in eczema (搜索) patients may mechanistically explain the increased susceptibility to herpes zoster (搜索) reactivation.
A new analysis published in the Journal der Deutschen Dermatologischen Gesellschaft (JDDG) reveals that individuals with eczema (搜索)—also known as atopic dermatitis (搜索)—face a significantly elevated risk of developing shingles (搜索) (herpes zoster (搜索)), a painful reactivation of the varicella zoster virus (搜索) that causes chickenpox.
Drawing on primary care data from a UK database spanning 1997 to 2023 and encompassing 113,426,267 individuals, researchers found that people with eczema (搜索) had a 28% higher risk of developing shingles (搜索) after adjusting for multiple influencing factors, including age, sex, comorbidities, cigarette smoking, and alcohol use.
"These findings may inform vaccination guidelines," the study authors wrote.
Eczema (搜索) Severity Drives Risk, Immunosuppressants Play Minimal Role
The analysis demonstrated a clear dose-response relationship: shingles (搜索) risk increased in tandem with the severity of eczema (搜索). Notably, the use of immunosuppressant medications—commonly prescribed for moderate-to-severe atopic dermatitis (搜索)—had only a minimal effect on shingles risk, suggesting that the underlying disease process itself, rather than its treatment, may be the primary driver of increased susceptibility.
Mechanistically, the researchers point to an altered skin immune response in people with eczema (搜索) as a potential explanation for the elevated risk. Eczema is a chronic inflammatory skin condition characterized by skin barrier dysfunction and immune dysregulation, which may create conditions favorable for the reactivation of dormant varicella zoster virus (搜索) residing in nerve tissue.
Clinical Implications and Vaccination Considerations
Shingles (搜索) occurs when the varicella zoster virus (搜索), which remains latent in nerve tissue following a chickenpox infection, reactivates—often later in life or in immunosuppressed individuals. The condition causes a painful, blistering rash and can lead to persistent nerve pain known as postherpetic neuralgia.
Currently, shingles (搜索) vaccination programs in many countries target older adults and immunocompromised populations. In Australia, for instance, the recombinant zoster vaccine is provided free to adults aged 65 and over, Aboriginal and Torres Strait Islander people aged 50 and over, and immunocompromised individuals aged 18 and over. The vaccine is recommended but not subsidized for others aged 50 and above, with out-of-pocket costs for the two-dose regimen reaching approximately A$560.
The new findings raise important questions about whether individuals with eczema (搜索)—particularly those with moderate-to-severe disease—should be considered for earlier or prioritized shingles (搜索) vaccination, independent of age-based criteria.
The study underscores the need for further research into the immunological mechanisms linking atopic dermatitis (搜索) and herpes zoster (搜索) reactivation, as well as health economic analyses to evaluate the potential benefit of expanding vaccination recommendations to this at-risk population.