Abstract
BackgroundAtopic dermatitis is the most common chronic inflammatory skin disease and presents a major public health burden worldwide. Recent observational studies revealed the potential association between atopic dermatitis with autoimmune disorders. However, there is no meta-analysis of the prevalence or incidence of autoimmune diseases in atopic dermatitis. Therefore, considering the potential clinical implications of these associations, we aimed to assess the risk of autoimmune diseases in patients with atopic dermatitis using this method.MethodsPubMed, Embase, and Web of Science were searched from inception to October, 2020. Observational studies which provided estimate effects with 95% CI or raw data were included. The quality of selected studies was evaluated using the Newcastle–Ottawa Scale. Odds ratio and relative risks were pooled using a random effects model and expressed with 95% confidence intervals.ResultsFourteen observational studies were included in this systematic review and meta-analysis. The random-effects meta-analysis of case–control and cross-sectional studies showed a significant association of atopic dermatitis with mutiple autoimmune diseases, including alopecia areata, celiac disease, Crohn’s disease, rheumatoid arthritis, systematic lupus erythematosus, ulcerative colitis and vitiligo. Furthermore, pooling of the results of cohort studies showed that patients with atopic dermatitis were more likely to develop these autoimmune diseases.ConclusionOur meta-analysis showed that patients with atopic dermatitis were at higher risk of multiple autoimmune diseases including alopecia areata, celiac disease, Crohn’s disease, rheumatoid arthritis, systematic lupus erythematosus, ulcerative colitis and vitiligo. It is important for early detection of the affected group so that timely management can be initiated. Dermatologists and allergists should be aware of the autoimmune diseases in patients with atopic dermatitis and develop interventions if necessary. Also, limited by the present research, we still require more large-scale studies to further establish the association between atopic dermatitis and autoimmune diseases.
Highlights
Atopic dermatitis (AD), known as atopic eczema, is the most common chronic inflammatory skin disease characterized by intense itching and recurrent eczematous lesions
Autoimmune disease is defined as a cluster of more than ninety diseases sharing a common pathogenesis of selfreactive adaptive immune response
Search strategy PubMed, Embase, and Web of Science databases were searched from inception to October 2020 using the following search terms: AND
Summary
Atopic dermatitis (AD), known as atopic eczema, is the most common chronic inflammatory skin disease characterized by intense itching and recurrent eczematous lesions. Recent large-scale population-based studies have reported the association between AD and several autoimmune diseases. There were no systematic review and meta-analysis exploring the link between AD and multiple autoimmune diseases. We performed this systematic review and meta-analysis based on the available literature to investigate the association between AD and autoimmune diseases. Atopic dermatitis is the most common chronic inflammatory skin disease and presents a major public health burden worldwide. Recent observational studies revealed the potential association between atopic dermatitis with autoimmune disorders. There is no meta-analysis of the prevalence or incidence of autoimmune diseases in atopic dermatitis. Considering the potential clinical implications of these associations, we aimed to assess the risk of autoimmune diseases in patients with atopic dermatitis using this method
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