{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T13:39:35Z","timestamp":1770471575735,"version":"3.49.0"},"reference-count":36,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Derm Venereol"],"abstract":"<jats:p>Prurigo nodularis (PN) has been associated with autoimmune diseases, though longitudinal data are limited. This study investigates the risk of autoimmune disease development in PN patients using a global electronic health record database. This retrospective cohort study analysed data from the Global Collaborative Network within the TriNetX research network. Adults (\u2265\u200918\u00a0years) with PN were compared with propensity score-matched controls without PN. Matching considered age, sex, comorbidities, race, and socioeconomic status. Patients with prior autoimmune diseases or cancers were excluded. Incident autoimmune diseases, including systemic lupus erythematosus (SLE), Sj\u00f6gren\u2019s syndrome, psoriasis, ankylosing spondylitis (AS), rheumatoid arthritis (RA), Crohn\u2019s disease (CD), and ulcerative colitis (UC), were evaluated using hazard ratios (HR). Among 17,963 PN patients and the same amount of matched pairs, PN patients had higher risks for SLE (HR: 2.16, 95% CI: 1.44\u20133.24), Sj\u00f6gren\u2019s syndrome (HR: 1.86, 95% CI: 1.33\u20132.59), and psoriasis (HR: 3.20, 95% CI: 2.58\u20133.97). Stratified analysis revealed that female PN patients had higher risks for SLE and Sj\u00f6gren\u2019s syndrome, while psoriasis risk was elevated in both sexes, especially in males. Risks for AS, RA, CD, and UC were not significant. Sensitivity analyses validated these findings. In conclusion, PN is linked to increased risks for SLE, Sj\u00f6gren\u2019s syndrome, and psoriasis, highlighting the need for proactive screening and management of autoimmune diseases in PN patients.<\/jats:p>","DOI":"10.2340\/actadv.v105.43515","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T05:50:38Z","timestamp":1757051438000},"page":"adv43515","source":"Crossref","is-referenced-by-count":1,"title":["New-onset Autoimmune Diseases in Patients with Prurigo Nodularis: A Global-federated Retrospective Cohort Study"],"prefix":"10.2340","volume":"105","author":[{"given":"Hui-Chin","family":"Chang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chia-Chi","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yen-Ju","family":"Chu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei-Ting","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun-Feng","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Sheng","family":"Jhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Jung","family":"Su","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiu-Jau","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Torsten","family":"Zuberbier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuo-Yan","family":"Gau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1183","published-online":{"date-parts":[[2025,9,4]]},"reference":[{"key":"125782","doi-asserted-by":"crossref","unstructured":"Shao Y, Wang D, Zhu Y, Xiao Z, Jin T, Peng L, et al. Molecular mechanisms of pruritus in prurigo nodularis. Front Immunol 2023; 14: 1301817.","DOI":"10.3389\/fimmu.2023.1301817"},{"key":"125783","doi-asserted-by":"crossref","unstructured":"McCampbell LE, Zaino ML, Ranpariya M, Patel T, Feldman SR. Systemic medication for the treatment of prurigo nodularis: a systematic review. J Cutan Med Surg 2023; 27: 641\u2013645.","DOI":"10.1177\/12034754231211797"},{"key":"125784","doi-asserted-by":"crossref","unstructured":"Williams KA, Huang AH, Belzberg M, Kwatra SG. Prurigo nodularis: pathogenesis and management. J Am Acad Dermatol 2020; 83: 1567\u20131575.","DOI":"10.1016\/j.jaad.2020.04.182"},{"key":"125785","doi-asserted-by":"crossref","unstructured":"Brooks SG, Yosipovitch G. Prurigo nodularis in 2025: current and emerging treatments. Clin Dermatol 2025; S0738-081X(25)00096-3.","DOI":"10.1016\/j.clindermatol.2025.03.013"},{"key":"125786","doi-asserted-by":"crossref","unstructured":"Geng RSQ, Sood S, Waked J, Mahmood R, Maliyar K, Sachdeva M, et al. Disease severity and pruritus treatment outcomes in prurigo nodularis: a systematic review of randomized-controlled trials. J Am Acad Dermatol 2025; 93: 263\u2013265.","DOI":"10.1016\/j.jaad.2025.03.009"},{"key":"125787","doi-asserted-by":"crossref","unstructured":"Huang AH, Canner JK, Khanna R, Kang S, Kwatra SG. Real-world prevalence of prurigo nodularis and burden of associated diseases. J Invest Dermatol 2020; 140: 480\u2013483.e484.","DOI":"10.1016\/j.jid.2019.07.697"},{"key":"125788","doi-asserted-by":"crossref","unstructured":"Woo YR, Wang S, Sohn KA, Kim HS. Epidemiology, comorbidities, and prescription patterns of Korean prurigo nodularis patients: a multi-institution study. J Clin Med 2021; 11.","DOI":"10.3390\/jcm11010095"},{"key":"125789","doi-asserted-by":"crossref","unstructured":"Gau S-Y, Lo S-W, Hsu C, Chen S-J, Zuberbier T, Chang H-C. Human papillomavirus infection is associated with increased risk of new-onset hidradenitis suppurativa: a population-based cohort study. J Am Acad Dermatol 2025; 92: 444\u2013451.","DOI":"10.1016\/j.jaad.2024.10.055"},{"key":"125790","doi-asserted-by":"crossref","unstructured":"Chang H-C, Lin C-Y, Guo Y-C, Lu H-Y, Lee C-Y, Wu M-C, et al. Association between hidradenitis suppurativa and atopic diseases: a multi-center, propensity-score-matched cohort study. Int J Med Sci 2024; 21: 299\u2013305.","DOI":"10.7150\/ijms.90086"},{"key":"125791","doi-asserted-by":"crossref","unstructured":"Chang H-C, Wu C-L, Chiu T-M, Liao W-C, Gau S-Y. Risk of osteoarthritis in patients with hidradenitis suppurativa: a global federated health network analysis. Front Immunol 2023; 14.","DOI":"10.3389\/fimmu.2023.1285560"},{"key":"125792","doi-asserted-by":"crossref","unstructured":"Roh YS, Marani M, Choi U, Sutaria N, Parthasarathy V, Deng J, et al. Validation of International Classification of Diseases Tenth Revision code for prurigo nodularis. J Am Acad Dermatol 2022; 87: 482\u2013484.","DOI":"10.1016\/j.jaad.2021.10.026"},{"key":"125793","doi-asserted-by":"crossref","unstructured":"Fry L, Baker BS, Powles AV, Engstrand L. Psoriasis is not an autoimmune disease? Exp Dermatol 2015; 24: 241\u2013244.","DOI":"10.1111\/exd.12572"},{"key":"125794","doi-asserted-by":"crossref","unstructured":"Liu A, Liao P, Jiang H, Huang S, Li S, Wei JC, et al. COVID-19 vaccination reduces new-onset fibromyalgia risk in survivors. BMC Med 2025; 23: 255.","DOI":"10.1186\/s12916-025-04069-z"},{"key":"125795","doi-asserted-by":"crossref","unstructured":"Li CP, Lo SW, Tsai RY, Chang HC, Gau SY. New-onset hidradenitis suppurativa in psoriasis patients: a multi-center, retrospective cohort study. Life (Basel, Switzerland) 2024; 14.","DOI":"10.3390\/life14060730"},{"key":"125796","doi-asserted-by":"crossref","unstructured":"Schuler CFt, Billi AC, Maverakis E, Tsoi LC, Gudjonsson JE. Novel insights into atopic dermatitis. J Allergy Clin Immunol 2023; 151: 1145\u20131154.","DOI":"10.1016\/j.jaci.2022.10.023"},{"key":"125797","doi-asserted-by":"crossref","unstructured":"Yang G, Seok JK, Kang HC, Cho YY, Lee HS, Lee JY. Skin barrier abnormalities and immune dysfunction in atopic dermatitis. Int J Mol Sci 2020; 21.","DOI":"10.3390\/ijms21082867"},{"key":"125798","doi-asserted-by":"crossref","unstructured":"Vermeer E, Hebing RCF, van de Meeberg MM, Lin M, de Meij TGJ, Struys EA, et al. Oral versus subcutaneous methotrexate in immune-mediated inflammatory disorders: an update of the current literature. Curr Rheumatol Rep 2023; 25: 276\u2013284.","DOI":"10.1007\/s11926-023-01116-7"},{"key":"125799","doi-asserted-by":"crossref","unstructured":"Ma F, Gharaee-Kermani M, Tsoi LC, Plazyo O, Chaskar P, Harms P, et al. Single-cell profiling of prurigo nodularis demonstrates immune-stromal crosstalk driving profibrotic responses and reversal with nemolizumab. J Allergy Clin Immunol 2024; 153: 146\u2013160.","DOI":"10.1016\/j.jaci.2023.07.005"},{"key":"125800","doi-asserted-by":"crossref","unstructured":"Rendon A, Sch\u00e4kel K. Psoriasis pathogenesis and treatment. Int J Mol Sci 2019; 20.","DOI":"10.3390\/ijms20061475"},{"key":"125801","doi-asserted-by":"crossref","unstructured":"Kwatra SG. Breaking the itch\u2013scratch cycle in prurigo nodularis. N Engl J Med 2020; 382: 757\u2013758.","DOI":"10.1056\/NEJMe1916733"},{"key":"125802","doi-asserted-by":"crossref","unstructured":"Jiang Q, Yang G, Xiao F, Xie J, Wang S, Lu L, et al. Role of Th22 Cells in the pathogenesis of autoimmune diseases. Front Immunol 2021; 12: 688066.","DOI":"10.3389\/fimmu.2021.688066"},{"key":"125803","doi-asserted-by":"crossref","unstructured":"Gong F, Wu J, Zhou P, Zhang M, Liu J, Liu Y, et al. Interleukin-22 might act as a double-edged sword in type 2 diabetes and coronary artery disease. Mediators Inflamm 2016; 2016: 8254797.","DOI":"10.1155\/2016\/8254797"},{"key":"125804","doi-asserted-by":"crossref","unstructured":"Daud\u00e9n E, Casta\u00f1eda S, Su\u00e1rez C, Garc\u00eda-Campayo J, Blasco AJ, Aguilar MD, et al. Clinical practice guideline for an integrated approach to comorbidity in patients with psoriasis. J Eur Acad Dermatol Venereol 2013; 27: 1387\u20131404.","DOI":"10.1111\/jdv.12024"},{"key":"125805","doi-asserted-by":"crossref","unstructured":"Zheng Y, Li T. Interleukin-22, a potent target for treatment of non-autoimmune diseases. Hum Vaccin Immunother 2018; 14: 2811\u20132819.","DOI":"10.1080\/21645515.2018.1509649"},{"key":"125806","doi-asserted-by":"crossref","unstructured":"Mashiko S, Bouguermouh S, Rubio M, Baba N, Bissonnette R, Sarfati M. Human mast cells are major IL-22 producers in patients with psoriasis and atopic dermatitis. J Allergy Clin Immunol 2015; 136: 351\u2013359.e351.","DOI":"10.1016\/j.jaci.2015.01.033"},{"key":"125807","doi-asserted-by":"crossref","unstructured":"Wolk K, Witte E, Wallace E, D\u00f6cke WD, Kunz S, Asadullah K, et al. IL-22 regulates the expression of genes responsible for antimicrobial defense, cellular differentiation, and mobility in keratinocytes: a potential role in psoriasis. Eur J Immunol 2006; 36: 1309\u20131323.","DOI":"10.1002\/eji.200535503"},{"key":"125808","doi-asserted-by":"crossref","unstructured":"Belzberg M, Alphonse MP, Brown I, Williams KA, Khanna R, Ho B, et al. Prurigo nodularis is characterized by systemic and cutaneous T helper 22 immune polarization. J Invest Dermatol 2021; 141: 2208\u20132218.e2214.","DOI":"10.1016\/j.jid.2021.02.749"},{"key":"125809","doi-asserted-by":"crossref","unstructured":"Furue M. Regulation of filaggrin, loricrin, and involucrin by IL-4, IL-13, IL-17A, IL-22, AHR, and NRF2: pathogenic implications in atopic dermatitis. Int J Mol Sci 2020; 21.","DOI":"10.3390\/ijms21155382"},{"key":"125810","doi-asserted-by":"crossref","unstructured":"Sutaria N, Alphonse MP, Roh YS, Choi J, Parthasarathy V, Deng J, et al. Cutaneous transcriptomics identifies fibroproliferative and neurovascular gene dysregulation in prurigo nodularis compared with psoriasis and atopic dermatitis. J Invest Dermatol 2022; 142: 2537\u20132540.","DOI":"10.1016\/j.jid.2022.02.010"},{"key":"125811","doi-asserted-by":"crossref","unstructured":"Su Z, Zeng YP. Dupilumab-associated psoriasis and psoriasiform manifestations: a scoping review. Dermatology 2023; 239: 646\u2013657.","DOI":"10.1159\/000530608"},{"key":"125812","doi-asserted-by":"crossref","unstructured":"Kabbani M, Mboyo Mpita G, Benhadou F. Ustekinumab plus dupilumab in the treatment of concomitant psoriasis and prurigo nodularis. J Eur Acad Dermatol Venereol 2022; 36: e1050\u2013e1051.","DOI":"10.1111\/jdv.18445"},{"key":"125813","doi-asserted-by":"crossref","unstructured":"McInnes IB, Schett G. The pathogenesis of rheumatoid arthritis. N Engl J Med 2011; 365: 2205\u20132219.","DOI":"10.1056\/NEJMra1004965"},{"key":"125814","doi-asserted-by":"crossref","unstructured":"Strazzulla LC, Wang EHC, Avila L, Lo Sicco K, Brinster N, Christiano AM, et al. Alopecia areata: disease characteristics, clinical evaluation, and new perspectives on pathogenesis. J Am Acad Dermatol 2018; 78: 1\u201312.","DOI":"10.1016\/j.jaad.2017.04.1141"},{"key":"125815","doi-asserted-by":"crossref","unstructured":"Yook HJ, Lee JH. Prurigo nodularis: pathogenesis and the horizon of potential therapeutics. Int J Mol Sci 2024; 25: 5164.","DOI":"10.3390\/ijms25105164"},{"key":"125816","doi-asserted-by":"crossref","unstructured":"Augustin M, Garbe C, Hagenstr\u00f6m K, Petersen J, Pereira MP, St\u00e4nder S. Prevalence, incidence and presence of comorbidities in patients with prurigo and pruritus in Germany: a population-based claims data analysis. J Eur Acad Dematol Venereol 2021; 35: 2270\u20132276.","DOI":"10.1111\/jdv.17485"},{"key":"125817","doi-asserted-by":"crossref","unstructured":"Gau SY. Methotrexate use and liver outcomes in psoriasis and rheumatoid arthritis patients: a commentary on \u201cRisk of liver disease in patients with psoriasis, psoriatic arthritis and rheumatoid arthritis receiving methotrexate: A population-based study\u201d. J Am Acad Dermatol 2021; 85: e399\u2013e400.","DOI":"10.1016\/j.jaad.2021.07.069"}],"container-title":["Acta Dermato-Venereologica"],"original-title":[],"link":[{"URL":"https:\/\/medicaljournalssweden.se\/actadv\/article\/download\/43515\/51332","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicaljournalssweden.se\/actadv\/article\/download\/43515\/51332","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T05:50:58Z","timestamp":1757051458000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicaljournalssweden.se\/actadv\/article\/view\/43515"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,4]]},"references-count":36,"URL":"https:\/\/doi.org\/10.2340\/actadv.v105.43515","relation":{},"ISSN":["1651-2057","0001-5555"],"issn-type":[{"value":"1651-2057","type":"electronic"},{"value":"0001-5555","type":"print"}],"subject":[],"published":{"date-parts":[[2025,9,4]]}}}