Iron deficiency without anemia common with moderate-to-severe atopic dermatitis

by Lori Solomon

edited by Sadie Harley, reviewed by Andrew Zinin

 Editors’ notes

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Iron deficiency without anemia is a common feature of moderate-to-severe atopic dermatitis (AD), according to a study published in Nutrients.

Małgorzata Ponikowska, from Wroclaw Medical University in Poland, and colleagues characterized iron status in patients with AD and examined its relationship with disease severity and quality of life. The analysis included 86 adult patients with moderate-to-severe AD.

The researchers found that abnormalities in circulating iron biomarkers, indicative of iron deficiency, were prevalent in patients with AD: 45% of patients had low transferrin saturation (Tsat; <20%), 37% low ferritin, and 26% reduced serum iron, despite largely normal hemoglobin.

Patients with pro-inflammatory activation (as measured by elevated high-sensitivity C-reactive protein >5 mg/L) had a pattern characterized by lower iron and Tsat and higher soluble transferrin receptor levels.

Lower serum iron remained associated with worse Dermatology Life Quality Index scores in a multivariable analysis, while higher transferrin was associated with greater disease severity, measured by the Eczema Area and Severity Index and SCORing Atopic Dermatitis.

“In conclusion, our study identifies dysregulated iron homeostasis—indicative of iron deficiency—as a prevalent systemic feature of atopic dermatitis. These disturbances are linked to disease severity and impaired quality of life, suggesting that altered iron metabolism may represent a potentially modifiable systemic correlate of the AD phenotypes,” the authors write.

“Future studies should explore whether targeted correction of iron deficiency can improve patient outcomes.”

More information

Małgorzata Ponikowska et al, Dysregulated Iron Homeostasis in Atopic Dermatitis: Linking Iron Deficiency to Clinical Severity and Quality of Life, Nutrients (2025). DOI: 10.3390/nu17233743

Journal information: Nutrients

Key medical concepts

Atopic dermatitis Iron Deficiencies

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