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In a recent investigation of bone mineral density (BMD) in patients with moderate-to-severe AD, we found that one third of the patients had a low BMD, predominately males. This could be due to the use of topical corticosteroids or due to chronic inflammation. However, neither could be held responsible for the above finding. Low BMD at baseline does not seem to progress quickly, as assessed in a 2-year follow-up study. Treatment of low BMD is questionable as the effect of vitamin D and/or calcium supplementation on low BMD is controversial. We recommend performing long-term follow-up studies to assess the course of BMD over time from onset of AD., (Copyright © 2012 S. Karger AG, Basel.)

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease commonly treated with topical corticosteroids. The inflammatory nature of this disorder and the use of topical corticosteroids represent potential risk factors for bone loss., Objectives: The aim was to assess the prevalence of osteoporosis and osteopenia in adult patients with moderate to severe AD. In addition, the associations between topical/oral corticosteroid use and bone mineral density (BMD) and between disease activity and BMD were studied., Patients and Methods: We studied 125 adult patients with moderate to severe AD. Using dual-energy X-ray absorptiometry, BMD was measured at lumbar spine and hips. The cumulative dose of topical and oral corticosteroids was calculated from pharmacy prescription records. Lifestyle parameters were collected by a questionnaire. Biochemical parameters of bone metabolism and disease activity [serum concentration of thymus and activation-regulated chemokine (TARC) levels] were also measured., Results: Osteoporosis was documented in six patients (4.8%) and osteopenia in 41 patients (32.8%); 30.4% of the patients had a Z-score