title: Association between atopic dermatitis and contact sensitization: A systematic review and meta-analysis.
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).
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. Electronic address: hamann511@gmail.com.
authors.forename: Carsten R
authors.initials: CR
authors.lastname: Hamann
authors.affiliation: Department of Internal Medicine, Division of Dermatology, Ohio State University, Columbus, Ohio.
authors.forename: Dathan
authors.initials: D
authors.lastname: Hamann
authors.affiliation: Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
authors.forename: Alexander
authors.initials: A
authors.lastname: Egeberg
authors.affiliation: 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.
authors.forename: Jeanne D
authors.initials: JD
authors.lastname: Johansen
authors.affiliation: Departments of Dermatology, Preventive Medicine, and Medical Social Sciences, Feinberg School of Medicine at Northwestern University, Chicago, Illinois.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Silverberg
authors.affiliation: 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.
authors.forename: Jacob P
authors.initials: JP
authors.lastname: Thyssen
mesh_terms: D003876:Dermatitis, Atopic / Q000276:immunology*; D003877:Dermatitis, Contact / Q000276:immunology*; D006801:Humans
keywords: allergic contact dermatitis; atopic dermatitis; atopic risk factors; atopy; chromium; contact allergy; contact sensitization; eczema