{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T09:24:52Z","timestamp":1769160292081,"version":"3.49.0"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,1,25]],"date-time":"2023-01-25T00:00:00Z","timestamp":1674604800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Lymphocyte skin homing in atopic eczema (AE) may induce lymphopenia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine if AE is associated with lymphopenia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used UK primary care electronic health records (Clinical Practice Research Datalink GOLD) for a matched cohort study in adults (18\u2009years+) (1997\u20132015) with at least one recorded lymphocyte count. We matched people with AE to up to five people without. We used multivariable logistic regression to estimate the association between AE and lymphopenia (two low lymphocyte counts within 3\u00a0months) and linear mixed effects regression to estimate the association with absolute lymphocyte counts using all available counts. Cox proportional hazard models were used to investigate the effect of lymphopenia on common infections. We replicated the study using US survey data (National Health and Nutrition Examination Survey [NHANES]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 71,731 adults with AE and 126,349 adults without AE, we found an adjusted odds ratio (OR) for lymphopenia of 1.16 (95% CI: 1.09\u20131.23); the strength of association increased with increasing eczema severity. When comparing all recorded lymphocyte counts from adults with AE (<jats:italic>n<\/jats:italic>\u00a0=\u00a01,497,306) to those of people without AE (<jats:italic>n<\/jats:italic>\u00a0=\u00a04,035,870) we saw a lower mean lymphocyte (adjusted mean difference \u22120.047\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L [95% CI: \u22120.051 to \u22120.043]) in those with AE. The difference was larger for men, with increasing age, and with increasing AE severity and was present among people with AE not treated with immunosuppressive drugs. In NHANES (<jats:italic>n<\/jats:italic>\u00a0=\u00a022,624), the adjusted OR for lymphopenia in adults with AE was 1.30 (95% CI: 0.80\u20132.11), and the adjusted mean lymphocyte count difference was \u22120.03\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L (95% CI: \u22120.07 to 0.02). Despite having a lower lymphocyte count, adjusting for time with lymphopenia, did not alter risk estimates of infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Atopic eczema, including increasing AE severity, is associated with a decreased lymphocyte count, regardless of immunosuppressive drug use. Whether the lower lymphocyte count has wider health implications for people with severe eczema warrants further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.18841","type":"journal-article","created":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T10:23:19Z","timestamp":1673000599000},"page":"1190-1198","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The association between atopic eczema and lymphopenia: Results from a UK cohort study with replication in US survey data"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8922-6791","authenticated-orcid":false,"given":"Loes M.","family":"Hollestein","sequence":"first","affiliation":[{"name":"Department of Dermatology Erasmus University Medical Center  Rotterdam The Netherlands"},{"name":"Department of Research Netherlands Comprehensive Cancer Organization (IKNL)  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0023-8946","authenticated-orcid":false,"given":"Morgan Ya Fang","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of California San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ky\u2010Leigh","family":"Ang","sequence":"additional","affiliation":[{"name":"Department of Non\u2010communicable Disease Epidemiology London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6888-2212","authenticated-orcid":false,"given":"Harriet","family":"Forbes","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences University of Bristol  Bristol UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2551-410X","authenticated-orcid":false,"given":"Kathryn E.","family":"Mansfield","sequence":"additional","affiliation":[{"name":"Department of Non\u2010communicable Disease Epidemiology London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7736-6946","authenticated-orcid":false,"given":"Katrina","family":"Abuabara","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of California San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9168-6022","authenticated-orcid":false,"given":"Liam","family":"Smeeth","sequence":"additional","affiliation":[{"name":"Department of Non\u2010communicable Disease Epidemiology London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7022-7441","authenticated-orcid":false,"given":"Sin\u00e9ad M.","family":"Langan","sequence":"additional","affiliation":[{"name":"Department of Non\u2010communicable Disease Epidemiology London School of Hygiene and Tropical Medicine  London UK"},{"name":"Health Data Research UK  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,1,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31286-1"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.19580"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-1882"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/WOX.0b013e3181d675f8"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2015.03.032"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/09546634.2018.1451619"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/pai.13648"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-0207"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2017.01.030"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2018.11.028"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyv098"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2017.03.029"},{"key":"e_1_2_9_14_1","unstructured":"ShahA.Using electronic health records to investigate blood biomarkers and onset of cardiovascular diseases: example of differential white cell count. School of Life and Medical Sciences Faculty of Population Health Sciences Institute of Cardiovascular Science: University College London; 2015:269."},{"key":"e_1_2_9_15_1","unstructured":"CALIBER Lymphocyte counts phenotype. Available from:https:\/\/www.caliberresearch.org\/portal\/phenotypes\/lymphocytes. Accessed 12 Jan 2023."},{"key":"e_1_2_9_16_1","first-page":"1","article-title":"The national health and nutrition examination survey: sample design, 1999\u20102006","volume":"2","author":"Curtin LR","year":"2012","journal-title":"Vital Health Stat"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2004.00476.x"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2015.3065"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgast-2020-000573"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kez344"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kez349"},{"key":"e_1_2_9_22_1","unstructured":"Data. 2021. Available from:https:\/\/cprd.com\/Data. Accessed 12 Jan 2023."},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2009.03537.x"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2017.03.029"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.1998.02316.x"},{"key":"e_1_2_9_26_1","volume-title":"Skin conditions in the UK: a health care needs assessment","author":"Schofield J","year":"2009"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.19597"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2019.08.030"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k1786"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2020.1948"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2011.238386"},{"key":"e_1_2_9_32_1","first-page":"361","article-title":"The diagnosis of urinary tract infection: a systematic review","volume":"107","author":"Schmiemann G","year":"2010","journal-title":"Dtsch Arztebl Int"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199310283291808"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.21908"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.04.086"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.16411"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.16526"}],"container-title":["Journal of the European Academy of Dermatology and Venereology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdv.18841","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jdv.18841","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jdv.18841","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T08:33:53Z","timestamp":1692520433000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jdv.18841"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,25]]},"references-count":36,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1111\/jdv.18841"],"URL":"https:\/\/doi.org\/10.1111\/jdv.18841","archive":["Portico"],"relation":{},"ISSN":["0926-9959","1468-3083"],"issn-type":[{"value":"0926-9959","type":"print"},{"value":"1468-3083","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,25]]},"assertion":[{"value":"2022-09-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}