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J Am Acad Dermatol. 2015 Jun;72(6):992-1002. doi: 10.1016/j.jaad.2015.02.1116. Epub 2015 Apr 1.

Risk of lymphoma in patients with atopic dermatitis and the role of topical treatment: A systematic review and meta-analysis.

Author information

1
Department of Dermatology, Paul Sabatier University, Toulouse, France.
2
Department of Rheumatology, Bordeaux University Hospital, Bordeaux, France.
3
Department of Dermatology, University of New South Wales, Sydney, Australia.
4
Department of Dermatology, Paul Sabatier University, Toulouse, France. Electronic address: paul.c@chu-toulouse.fr.

Abstract

BACKGROUND:

There is controversy regarding a potential increased risk of lymphoma in patients with atopic dermatitis (AD).

OBJECTIVE:

To assess the risk of lymphoma and the role of topical treatments in patients with AD.

METHODS:

A systematic literature search and a separate meta-analysis were performed on case control and cohort studies.

RESULTS:

Of the 3979 articles retrieved, 24 references met the inclusion criteria. In cohort studies, the risk of lymphoma was slightly increased, with a relative risk (RR) of 1.43 (95% confidence interval [CI], 1.12-1.81). In case control studies, no significant increased risk of lymphoma was found, with an odds ratio (OR) of 1.18 (95% CI, 0.94-1.47). Severity of AD was a significant risk factor. Highly potent topical steroids were associated with an increased risk of lymphoma. For topical calcineurin inhibitors (TCIs), a significant association between tacrolimus and mostly skin lymphoma was found in 1 study.

LIMITATIONS:

Confusion between severe AD and cutaneous T-cell lymphoma may account for part of the increased risk of lymphoma in patients with AD.

CONCLUSION:

This systematic literature review shows a slightly increased risk of lymphoma in patients with AD. Severity of AD appears to be a significant risk factor. The role of topical steroids and TCIs is unlikely to be significant.

KEYWORDS:

atopic dermatitis; lymphoma; neoplasm; pimecrolimus; systematic review; tacrolimus; topical corticosteroids

PMID:
25840730
DOI:
10.1016/j.jaad.2015.02.1116
[Indexed for MEDLINE]

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