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J Am Acad Dermatol. 2017 Jul;77(1):70-78. doi: 10.1016/j.jaad.2017.02.001. Epub 2017 Apr 6.

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

Author information

1
Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. Electronic address: hamann511@gmail.com.
2
Department of Internal Medicine, Division of Dermatology, Ohio State University, Columbus, Ohio.
3
Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
4
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.
5
Departments of Dermatology, Preventive Medicine, and Medical Social Sciences, Feinberg School of Medicine at Northwestern University, Chicago, Illinois.

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.

KEYWORDS:

allergic contact dermatitis; atopic dermatitis; atopic risk factors; atopy; chromium; contact allergy; contact sensitization; eczema

PMID:
28392290
DOI:
10.1016/j.jaad.2017.02.001
[Indexed for MEDLINE]

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