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

Carsten R Hamann, Dathan Hamann, Alexander Egeberg, Jeanne D Johansen, Jonathan Silverberg, Jacob P Thyssen

Journal: Journal of the American Academy of Dermatology 2017;77(1):70-78

PMID: 28392290

Full Text on Elsevier Science View on PubMed

Abstract

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.

Address: Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. Electronic address: [email protected].; Department of Internal Medicine, Division of Dermatology, Ohio State University, Columbus, Ohio.; Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.; Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; National Allergy Research Centre, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.; Departments of Dermatology, Preventive Medicine, and Medical Social Sciences, Feinberg School of Medicine at Northwestern University, Chicago, Illinois.

DOI: 10.1016/j.jaad.2017.02.001

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MeSH Terms: Dermatitis, Atopic, Dermatitis, Contact, Humans