People with eczema are 44 percent more likely to think about suicide and 36 percent more likely to attempt it, according to a study published Wednesday.

The study, published in the Journal of the American Medical Association Dermatology, examined previous studies involving nearly 5 million participants and identifying more than 310,000 people with eczema.

“I was surprised by the magnitude — that’s really the pain that these patients are going through,” said Dr. April W. Armstrong, a co-author of the study. “I think what we see in clinic is that they’re suffering. But it takes it to a whole different level when people are thinking about potentially ending their lives over this disease.”

About 31 million Americans have eczema, with estimated 18 million adults and more than 9.6 million children suffering from atopic dermatitis, the most common form of the disease.

It can cause itchy, red patches all over the body and lead to serious health conditions like asthma, allergies, sleep disorders, depression and anxiety. The rashes can breed infection and ooze pus.

“The physical and psychosocial burden of [eczema] may contribute to the observed increased risk of suicidality,” the researchers said in the study. “Psychosocial factors, such as the stigmatization and shame experienced from their disease, and impairment of school or work performance may also contribute to the increased risk of suicidality seen in patients with [eczema].”

In one extreme case in June, a 23-year-old woman in Hong Kong mentioned her longtime skin disease in a note before killing her parents and taking her own life.

“People with eczema giving birth to kids are worse than poor people giving birth to kids,” Pang Ching-yu wrote on a message board before the murder, CNN reported.

“… there’s nothing you can do except to wait and die,” she wrote, adding that her “social life [was] all gone.”

In the U.S., suicide is the second leading cause of death for adolescents and the 10th leading cause of death for adults, according to federal statistics. An estimated 45,000 people took their lives in 2016, and more than half of U.S. states have reported a 30 percent increase in suicides since 1999.

People age 45 to 54 years old have the highest rates of suicide, although those rates are increasing faster among teenagers.

Dr. Armstrong, associate dean for clinical research at the Keck School of Medicine at the University of Southern California, said that while the study found a high percentage of eczema sufferers contemplating or attempting suicide, the statistics on actual suicides among that group were “inconclusive.”

She said not enough research has been done in that area, noting that her researchers found only two studies addressing the subject — one that showed an increase in suicides among eczema patients and another that showed no such increase.

Dr. Joseph Merola, a dermatologist and director of research at Harvard Medical School who wasn’t involved in the study, said the results are a “wake up call” in addressing the full needs of patients.

“I wouldn’t say it’s a shock but I do think, for me, the wake up call is about how do we work that into our busy practices and incorporate that into best practices for these conditions,” Dr. Merola said. “It’s important to remember that these diseases are more than skin-deep.”

Julie Block, CEO for the National Eczema Association, said the burden for patients is something the organization has long fought to raise awareness.

“We know that the scope of the seriousness of mental illness is under appreciated and has been for a very long time,” Ms. Block said.

A 2017 study funded by the association called the impact of the disease on patients and families “detrimental” to their well-being. More than half of parents of eczema patients surveyed in the study said they lose sleep over their children’s struggles, notice that other adults and children avoid their children and that they start avoiding other families to keep from discussing their child’s skin condition.

“It can be a very isolating disease,” Ms. Block said.

Ms. Block and Dr. Armstrong agree that excitement and hope are rising in the community over new medications and treatments making their way through the pipeline that are relieving symptoms with few side effects.

Last year, the Food and Drug Administration approved Dupixnet, one of the first new drugs to treat eczema in more than a decade and one that focuses on using the immune system to fight the disease.

“We call it the decade of eczema,” Ms. Block said. “We are excited that there is new hope and the industry is investing in new therapies for this disease after a very long, long, dry spell.”

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