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Br J Dermatol. 2018 Apr;178(4):879-888. doi: 10.1111/bjd.16147. Epub 2018 Feb 15.

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

Author information

1
Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Kildegaardsvej 28, DK-2900, Hellerup, Denmark.
2
National Allergy Research Centre (Department of Dermatology and Allergy), Herlev and Gentofte Hospital, University of Copenhagen, Kildegaardsvej 28, DK-2900, Hellerup, Denmark.
3
Departments of Dermatology, Preventive Medicine and Medical Social Sciences, Feinberg School of Medicine at Northwestern University, Chicago, IL, U.S.A.

Abstract

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.

PMID:
29172235
DOI:
10.1111/bjd.16147

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