Several Inflammatory Skin Diseases Associated with Increased Risk of Keratoconus

An increased risk of keratoconus development was found in patients with many inflammatory dermatologic conditions, including atopic dermatitis, psoriasis, seborrheic dermatitis and contact dermatitis, underscoring the potential shared inflammatory mechanisms in keratoconus pathogenesis and highlight the importance of vigilant ocular monitoring in high-risk populations. Photo: Irving Martínez Navé, OD. Click image to enlarge. In a recent study, researchers sought to evaluate whether inflammatory skin conditions—including atopic dermatitis, psoriasis, seborrheic dermatitis, contact dermatitis, urticaria and rosacea—are associated with an increased risk of keratoconus (KC). They found that all conditions are except for rosacea. The findings were reported in Cornea.Using the TriNetX Global Collaborative Network, researchers from Texas and New York matched adults (aged 18 to 40) diagnosed with these skin conditions between 2016 and 2019 with controls, adjusting for demographics and known KC risk factors.The study found that most examined inflammatory skin conditions were associated with an increased five-year risk of developing KC. Patients with atopic dermatitis exhibited a 2.32-fold increased five-year risk of keratoconus, those with psoriasis a 1.29-fold increased risk, those with seborrheic dermatitis a 1.64-fold increased risk and those with contact dermatitis a 1.55-fold increased risk. By contrast, rosacea did not show a significant association with KC development.The researchers suggest that these skin conditions elevate proinflammatory cytokines and disrupt collagen integrity in both the skin and the cornea. “Elevated levels of proinflammatory cytokines such as Interleukin-1b (IL), IL-6, IL17 and tumor necrosis factor alpha, which are commonly found in KC patients’ tears and corneal tissues, are also implicated in inflammatory skin conditions such as psoriasis, seborrheic dermatitis and contact dermatitis,” the authors wrote in their paper. “These elevated cytokine levels not only promote local inflammation but also disrupt collagen crosslinking, a critical process that provides structural stability to both the cornea and the skin.” In keratoconus, a reduction in natural collagen crosslinking leads to corneal thinning and ectasia. Similarly, inflammatory skin conditions associated with elevated cytokines can impair collagen structure and function, further highlighting the systemic impact of inflammation, the authors continued.The researchers emphasized in their paper the importance of vigilant ocular monitoring for patients with these high-risk inflammatory skin conditions. Early identification of KC could facilitate timely intervention, potentially reducing severe complications.With an appropriate index of suspicion and increased awareness of populations at heightened risk for keratoconus, it may be possible to diagnose patients with these conditions earlier in their disease course, potentially reducing complications associated with late-stage disease.“Our findings also raise important questions about the role of systemic inflammation in KC pathogenesis and whether early identification and management of inflammatory skin conditions could have preventive implications,” the authors concluded in their paper. “Further research and more detailed clinical data are warranted to better understand these relationships.”Click here for the journal source. Muayad J, Madsen JA, Sontam TR, et al. Real-world analysis of inflammatory dermatologic conditions and their association with keratoconus. Cornea. July 2026. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.