Atopic Dermatitis and Autoimmune Connective Tissue Diseases: Systematic Review and Meta-Analysis

Abstract

Introduction: The association between atopic dermatitis (AD) and autoimmune connective tissue diseases (ACTD) is not well-investigated. Objective: We aimed to conduct a systematic review and meta-analysis to assess the association between AD and ACTD. Methods: A comprehensive literature search was performed in PubMed, Embase, Cochrane Library and Web of Science to identify relevant studies. Studies included those providing original data on the prevalence, incidence, or risk of ACTD in people with AD. Pooled point prevalence and odds ratio (OR) with 95% confidence intervals (CI) were estimated using a random effect inverse variance method. Results: Twenty-three studies were included in the systematic review, of which 19 were included in the meta-analysis. The pooled ORs were statistically significant overall for autoimmune connective tissue diseases (ACTD), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Sjögren syndrome (SS), and polymyositis (PM)/dermatomyositis (DM), but not for ankylosing spondylitis (AS) or systemic scleroderma (SSc): any ACTD 1.76 (95% CI; 1.57–1.97, I2 =94%, p<0.01), RA 1.40 (95% CI; 1.23–1.58, I2 = 97%, p<0.01), SLE 1.92 (95% CI; 1.66–2.23, I2 = 86%, p<0.01), SS 2.08 (95% CI; 1.48–2.94, I2 = 92%, p<0.01), AS 1.75 (95% CI 1.32–2.33, I2 = 47%, p=0.13), PM/DM 2.37 (95% CI; 1.54–3.67, I2 = 73%, p<0.01), and SSc 2.75 (95% CI; 1.44–5.27, I2 = 60%, p=0.06). Conclusion: AD is associated with a significantly increased risk of ACTD, particularly RA, SLE, SS and PM/DM, while no significant association was observed with AS and SSc.

Keywords

• Atopic dermatitis
• autoimmune connective tissue diseases
• Sjögren’s syndrome
• systemic lupus erythematosus
• rheumatoid arthritis