The Temporal Relationships and Associations between Cutaneous Manifestations and Inflammatory Bowel Disease: A Nationwide Population-Based Cohort Study

Abstract

The temporal relationships between inflammatory bowel disease (IBD)-associated cutaneous manifestations and IBD remain uncertain, with existing evidence mostly from separate cross-sectional studies. We sought to determine the risks of IBD-related dermatologic diseases before and after the diagnosis of IBD. We identified 2847 cases of IBD and 14,235 matched controls from the Taiwan National Health Insurance Research Database between 2003 and 2014. The risks of cutaneous manifestations before and after the diagnosis of IBD were estimated with multivariable-adjusted analyses. At diagnosis, IBD was associated with atopic dermatitis (odds ratio (OR) = 1.61; 95% confidence interval (CI), 1.14–2.28), erythema nodosum (OR = 7.44; 95%CI, 3.75–14.77), aphthous stomatitis (OR = 2.01; 95%CI, 1.72–2.35), polyarteritis nodosa (OR = 5.67; 95%CI, 2.69–11.98), rosacea (OR = 1.67, 95%CI = 1.19–2.35), and cutaneous T cell lymphoma (OR = 21.27; 95%CI, 2.37–191.00). IBD was associated with the subsequent development of pyoderma gangrenosum (hazard ratio (HR) = 17.79; 95%CI, 6.35–49.86), erythema nodosum (HR = 6.54; 95%CI, 2.83–15.13), polyarteritis nodosa (HR = 2.69; 95%CI, 1.05–6.90), hidradenitis suppurativa (HR = 2.48; 95%CI, 1.03–5.97), psoriasis (HR = 2.19; 95%CI, 1.27–3.79), rosacea (HR = 1.92; 95%CI, 1.39–2.65), and aphthous stomatitis (HR = 1.45; 95%CI, 1.22–1.72). This study clarified the associations and temporal relationships between cutaneous manifestations and IBD, highlighting the need for interdisciplinary care in the patient with specific dermatologic diseases presenting with abdominal symptoms, or the IBD patients with cutaneous lesions.