40532 The Risk of Skin Cancer Among Patients with Atopic Dermatitis: A Population-Based Cohort Study

Conflicting data exist regarding the risk of skin cancer development in adult patients with atopic dermatitis (AD). The aim of this study is to evaluate the risk of developing melanoma and keratinocyte carcinomas (squamous cell carcinoma (SCC) and basal cell carcinoma (BCC)) among patients with AD. We conducted a retrospective cohort study using a nationwide commercial claims database (Optum’s de- identified Clinformatics® Data Mart Database (2007-2021)) to compare the incidence of melanoma, SCC, and BCC in insured patients aged 18 years or older with and without AD. A total of 60 million adult patients with and without AD were followed from 2007 to 2021. Compared to adults without AD, adults with AD had a significantly higher risk of developing melanoma (RR 1.23; 95% Cl, 1.20-1.26; p<.001), SCC (RR 1.25; 95% Cl, 1.23-1.26; p<.001), and BCC (RR 1.26; 95% Cl, 1.24-1.27; p<.001) after adjusting for age, sex, race/ethnicity, smoking history, sun exposure history, ultraviolet phototherapy, and ionizing radiation exposure. Specifically, adults with moderate-to-severe AD had a significantly higher risk of developing melanoma (RR 1.11; 95% Cl, 1.05-1.17; p<.001), SCC (RR 1.25; 95% Cl, 1.22-1.28; p<.001), and BCC (RR 1.17; 95% Cl, 1.14-1.20; p<.001) compared to adults with mild AD. In conclusion, our findings support an increased risk of melanoma, SCC, and BCC development in adult patients with AD regardless of AD severity. More mechanistic studies are necessary to understand AD and the development of skin cancers.