Systematic Review of Accelerated Epigenetic Aging in Chronic Inflammatory Dermatology Conditions

ABSTRACT Although dermatologic conditions primarily manifest on the skin, an increasing amount of evidence demonstrates that these inflammatory conditions can have a deeper impact on our systemic health. The use of epigenetics to measure biological age, instead of chronological age, can give us insight into the systemic burden of these diseases on aging. We aimed to understand the degree to which each dermatological condition affects biological aging. A systematic review was performed of PubMed, Embase, and Web of Science to identify all publications that measured biological age in dermatological patients using epigenetic clocks. Six articles involved the following conditions: atopic dermatitis (AD) (1), hidradenitis suppurativa (HS) (1), and psoriasis (PsO) (4). Notably, patients with psoriatic arthritis, but not psoriasis alone, demonstrated significantly increased epigenetic aging compared to controls. Pediatric AD patients had an increase in the rate of biological aging as measured by the Horvath, Skin and Blood, PhenoAge, and GrimAge clocks. HS patients were found to have an increased biological age when assessing tissue from affected skin. Further research is needed to investigate correlations between disease severity and epigenetic aging, and for expansion into other dermatological diseases. Additionally, epigenetic clocks need to be developed that utilize different subsets of inflammation more broadly and skin biomarkers to provide a more accurate estimation for chronic inflammatory dermatological conditions.