The association between atopic dermatitis and hand eczema: a systematic review and meta-analysis

TY - JOUR

T1 - The association between atopic dermatitis and hand eczema

T2 - a systematic review and meta-analysis

AU - Ruff, S M D

AU - Engebretsen, K A

AU - Zachariae, C

AU - Johansen, J D

AU - Silverberg, J I

AU - Egeberg, A

AU - Thyssen, J P

N1 - © 2017 British Association of Dermatologists.

PY - 2018/4

Y1 - 2018/4

N2 - BACKGROUND: Atopic dermatitis (AD) and hand eczema (HE) are common chronic and relapsing inflammatory skin conditions that often co-occur.OBJECTIVES: While several studies have addressed their relationship, the exact association estimate is unknown.METHODS: We systematically reviewed published literature on the association between AD and HE in PubMed, Embase and Web of Science using the following search terms: (atopic dermatitis OR atopic eczema) AND (hand dermatitis OR hand eczema). Meta-analyses were then performed to examine the association between AD and the point, 1-year and lifetime prevalence of HE, respectively.RESULTS: We identified 35 relevant studies, of which 26 were included in the meta-analyses. AD was associated with an increased prevalence of HE with regard to point [odds ratio (OR) 2·35; 95% confidence interval (CI) 1·47-3·76], 1-year (OR 4·29; 95% CI 3·13-5·88) and lifetime prevalence (OR 4·06; 95% CI 2·72-6·06). Furthermore, positive associations between AD and occupational HE were identified when assessing the 1-year (OR 4·31; 95% CI 2·08-8·91) and lifetime prevalence (OR 2·81; 95% CI 2·08-3·79). Similar positive associations were found in the general population studies, i.e. OR 4·19 (95% CI 3·46-5·08) and OR 5·69 (95% CI 4·41-7·36).CONCLUSIONS: Important study limitations include the wide use of questionnaire studies, and lack of prospective studies as well as poor clinical phenotype descriptions. In conclusion, our systematic review and meta-analysis showed that patients with AD had a strongly increased prevalence of HE. Clinicians should continue to guide patients with AD away from occupations with a high risk of HE.

AB - BACKGROUND: Atopic dermatitis (AD) and hand eczema (HE) are common chronic and relapsing inflammatory skin conditions that often co-occur.OBJECTIVES: While several studies have addressed their relationship, the exact association estimate is unknown.METHODS: We systematically reviewed published literature on the association between AD and HE in PubMed, Embase and Web of Science using the following search terms: (atopic dermatitis OR atopic eczema) AND (hand dermatitis OR hand eczema). Meta-analyses were then performed to examine the association between AD and the point, 1-year and lifetime prevalence of HE, respectively.RESULTS: We identified 35 relevant studies, of which 26 were included in the meta-analyses. AD was associated with an increased prevalence of HE with regard to point [odds ratio (OR) 2·35; 95% confidence interval (CI) 1·47-3·76], 1-year (OR 4·29; 95% CI 3·13-5·88) and lifetime prevalence (OR 4·06; 95% CI 2·72-6·06). Furthermore, positive associations between AD and occupational HE were identified when assessing the 1-year (OR 4·31; 95% CI 2·08-8·91) and lifetime prevalence (OR 2·81; 95% CI 2·08-3·79). Similar positive associations were found in the general population studies, i.e. OR 4·19 (95% CI 3·46-5·08) and OR 5·69 (95% CI 4·41-7·36).CONCLUSIONS: Important study limitations include the wide use of questionnaire studies, and lack of prospective studies as well as poor clinical phenotype descriptions. In conclusion, our systematic review and meta-analysis showed that patients with AD had a strongly increased prevalence of HE. Clinicians should continue to guide patients with AD away from occupations with a high risk of HE.

U2 - 10.1111/bjd.16147

DO - 10.1111/bjd.16147

M3 - Review

C2 - 29172235

SN - 0007-0963

VL - 178

SP - 879

EP - 888

JO - British Journal of Dermatology

JF - British Journal of Dermatology

IS - 4

ER -