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The association between atopic dermatitis and hand eczema: a systematic review and meta-analysis.
Br J Dermatol 2018; 178(4):879-888BJ

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.

Authors+Show Affiliations

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

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

29172235

Citation

Ruff, S M D., et al. "The Association Between Atopic Dermatitis and Hand Eczema: a Systematic Review and Meta-analysis." The British Journal of Dermatology, vol. 178, no. 4, 2018, pp. 879-888.
Ruff SMD, Engebretsen KA, Zachariae C, et al. The association between atopic dermatitis and hand eczema: a systematic review and meta-analysis. Br J Dermatol. 2018;178(4):879-888.
Ruff, S. M. D., Engebretsen, K. A., Zachariae, C., Johansen, J. D., Silverberg, J. I., Egeberg, A., & Thyssen, J. P. (2018). The association between atopic dermatitis and hand eczema: a systematic review and meta-analysis. The British Journal of Dermatology, 178(4), pp. 879-888. doi:10.1111/bjd.16147.
Ruff SMD, et al. The Association Between Atopic Dermatitis and Hand Eczema: a Systematic Review and Meta-analysis. Br J Dermatol. 2018;178(4):879-888. PubMed PMID: 29172235.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The association between atopic dermatitis and hand eczema: a systematic review and meta-analysis. AU - Ruff,S M D, AU - Engebretsen,K A, AU - Zachariae,C, AU - Johansen,J D, AU - Silverberg,J I, AU - Egeberg,A, AU - Thyssen,J P, Y1 - 2018/02/15/ PY - 2017/09/18/accepted PY - 2017/11/25/pubmed PY - 2019/9/14/medline PY - 2017/11/25/entrez SP - 879 EP - 888 JF - The British journal of dermatology JO - Br. J. Dermatol. VL - 178 IS - 4 N2 - 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. SN - 1365-2133 UR - https://www.unboundmedicine.com/medline/citation/29172235/The_association_between_atopic_dermatitis_and_hand_eczema:_a_systematic_review_and_meta_analysis_ L2 - https://doi.org/10.1111/bjd.16147 DB - PRIME DP - Unbound Medicine ER -