Association between atopic dermatitis and contact sensitization: A systematic review and meta-analysis

TY - JOUR

T1 - Association between atopic dermatitis and contact sensitization

T2 - A systematic review and meta-analysis

AU - Hamann, Carsten R

AU - Hamann, Dathan

AU - Egeberg, Alexander

AU - Johansen, Jeanne D

AU - Silverberg, Jonathan

AU - Thyssen, Jacob P

N1 - Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

PY - 2017/7

Y1 - 2017/7

N2 - BACKGROUND: It is unclear whether patients with atopic dermatitis (AD) have an altered prevalence or risk for contact sensitization. Increased exposure to chemicals in topical products together with impaired skin barrier function suggest a higher risk, whereas the immune profile suggests a lower risk.OBJECTIVE: To perform a systematic review and meta-analysis of the association between AD and contact sensitization.METHODS: The PubMed/Medline, Embase, and Cochrane databases were searched for articles that reported on contact sensitization in individuals with and without AD.RESULTS: The literature search yielded 10,083 citations; 417 were selected based on title and abstract screening and 74 met inclusion criteria. In a pooled analysis, no significant difference in contact sensitization between AD and controls was evident (random effects model odds ratio [OR] = 0.891; 95% confidence interval [CI] = 0.771-1.03). There was a positive correlation in studies that compared AD patients with individuals from the general population (OR 1.50, 95% CI 1.23-1.93) but an inverse association when comparing with referred populations (OR 0.753, 95% CI 0.63-0.90).LIMITATIONS: Included studies used different tools to diagnose AD and did not always provide information on current or past disease. Patch test allergens varied between studies.CONCLUSION: No overall relationship between AD and contact sensitization was found. We recommend that clinicians consider patch testing AD patients when allergic contact dermatitis is suspected.

AB - BACKGROUND: It is unclear whether patients with atopic dermatitis (AD) have an altered prevalence or risk for contact sensitization. Increased exposure to chemicals in topical products together with impaired skin barrier function suggest a higher risk, whereas the immune profile suggests a lower risk.OBJECTIVE: To perform a systematic review and meta-analysis of the association between AD and contact sensitization.METHODS: The PubMed/Medline, Embase, and Cochrane databases were searched for articles that reported on contact sensitization in individuals with and without AD.RESULTS: The literature search yielded 10,083 citations; 417 were selected based on title and abstract screening and 74 met inclusion criteria. In a pooled analysis, no significant difference in contact sensitization between AD and controls was evident (random effects model odds ratio [OR] = 0.891; 95% confidence interval [CI] = 0.771-1.03). There was a positive correlation in studies that compared AD patients with individuals from the general population (OR 1.50, 95% CI 1.23-1.93) but an inverse association when comparing with referred populations (OR 0.753, 95% CI 0.63-0.90).LIMITATIONS: Included studies used different tools to diagnose AD and did not always provide information on current or past disease. Patch test allergens varied between studies.CONCLUSION: No overall relationship between AD and contact sensitization was found. We recommend that clinicians consider patch testing AD patients when allergic contact dermatitis is suspected.

KW - Dermatitis, Atopic/immunology

KW - Dermatitis, Contact/immunology

KW - Humans

U2 - 10.1016/j.jaad.2017.02.001

DO - 10.1016/j.jaad.2017.02.001

M3 - Review

C2 - 28392290

SN - 0190-9622

VL - 77

SP - 70

EP - 78

JO - American Academy of Dermatology. Journal

JF - American Academy of Dermatology. Journal

IS - 1

ER -