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 on PubMed, Embase, Cochrane Library, and Web of Science to identify relevant studies, which 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-one studies were included in the systematic review, of which 18 were included in the meta-analysis. The pooled ORs were statistically significant overall for 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 or SSc.