Prevalence of skin disorders and associated factors among patients with celiac disease: a cross-sectional study

Abstract

Background: While celiac disease (CD) ordinarily presents with gastrointestinal manifestations, extraintestinal appearances may also happen. Although cutaneous manifestations are one of the most common extraintestinal manifestations of CD, little is known about their prevalence and associated factors. This study aims to determine the prevalence of cutaneous manifestations and related factors in CD patients. Methods: This cross-sectional study enrolled CD patients referred to the National Celiac Registry, for whom a diagnosis of CD was confirmed through clinical examination, serological testing, and intestinal biopsy. Data on demographic characteristics, CD staging, clinical manifestations, underlying comorbidities, and family history (FH) of diseases were collected. Data were analyzed using SPSS version 25.0. A p-value less than 0.05 was considered significant. Results: Of the 4357 enrolled CD patients (male 65.7%), 18.20% had cutaneous manifestations, with eczema (3.73%), dermatitis herpetiformis (3.46%), and psoriasis (0.71%) being the most common disorders. The FH of skin disorders (Odds ratio (OR)=7.99, 95% confidence interval (CI) 2.44-26.13, p=0.00), osteoarthritis (OR=6.15, 95% CI 1.15-32.78, p=0.03), Sjögren syndrome (OR=4.82, 95% CI 1.98-11.73, p=0.00), mouth aphthae (OR=3.10, 95% CI 1.80-5.32, p=0.00), thalassemia (OR=2.78, 95% CI 1.19-6.50, p=0.01), constipation (OR =1.62, 95% CI 1.10-2.38, p=0.01), and iron deficiency anemia (IDA) (OR=1.54, 95% CI 1.05-2.24, p=0.02) were independent predictors, and type I diabetes mellitus (OR=0.20, 95% CI 0.05-0.81, p=0.02) was a protective factor for skin diseases. Conclusion: Considering the higher probability of cutaneous manifestations in CD patients, regular clinical evaluation of these patients is recommended for timely diagnosis and management of underlying skin diseases.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

The author(s) received no specific funding for this work.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The present study was conducted in accordance with the declaration of Helsinki Principles and approved by the Local Ethics Committee of Tehran University of Medical Sciences (IR.TUMS.DDRI.REC.1403.038). Written informed consent was signed by all patients.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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Data Availability

All relevant data are within the manuscript and its Supporting Information files.

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