Previous studies found conflicting results about the commonality of different atopic dermatitis (AD) signs and symptoms.
To determine the prevalences of AD characteristics and differences by region ...and age.
A systematic review was performed of all published studies in MEDLINE, EMBASE, SCOPUS, LILACS, Cochrane, China National Knowledge Infrastructure, Taiwan Electronic Periodical Services, and CiNii that analyzed the proportion of AD characteristics. Two reviewers performed a review study titles and/or abstracts and data abstraction.
In all, 101 studies reported proportion of AD features with sufficient data for meta-analysis. The most prevalent AD features were pruritus, lichenification, and xerosis. There were differences in AD characteristics by study region. Flexural involvement was less commonly reported in India, the Americas, and Iran. Studies from East Asian reported more erythroderma and truncal, extensor, scalp, and auricular involvement. Studies from Southeast Asia reported more exudative eczema, truncal involvement, lichenification, and prurigo nodularis. Studies from Iran reported more head, face, and neck involvement; pityriasis alba; and xerosis. Studies from Africa reported more papular lichenoid lesions, palmar hyperlinearity, ichthyosis, and orbital darkening.
Heterogeneity between studies and limited reporting of certain AD clinical characteristics.
AD characteristics are heterogeneous and vary by region and age.
Hand eczema is a common inflammatory condition of the skin that has been linked to hand hygiene. This systematic review and meta‐analysis aims to determine the risks of hand eczema associated with ...hand hygiene, including frequency of hand washing, wet work and use of alcohol hand rub. A comprehensive search of MEDLINE, EMBASE and Cochrane Library was performed for cohort, case–control or cross‐sectional studies that analysed the association between hand hygiene and risk of hand eczema. Results of individual studies were presented in respective forest plots and pooled summary relative risks were estimated using a random‐effects model. Forty‐five studies were included in the analysis. Hand washing at least 8–10 times daily significantly increased risk of hand eczema (relative risk RR 1.51; 95% confidence interval CI: 1.35–1.68; p < 0.001). The risk was related to hand washing frequency, with higher pooled RR of 1.66 (95% CI: 1.51–1.83; p < 0.001) with increased hand washing at least 15–20 times daily. However, use of alcohol‐based hand sanitizer was not significantly associated with risk of hand eczema. Given the widespread implementation of hand hygiene practices during the COVID‐19 pandemic, there is a pertinent need to understand skin care habits specific to the hands to avoid a greater incidence of hand eczema.
The use of masks for infection control was common in the COVID‐19 pandemic. As numerous cross‐sectional studies have suggested a link between the use of such masks and various facial dermatoses, a ...systematic review and meta‐analysis of published studies was conducted to evaluate this association, as well as potential risk factors for the development of such facial dermatoses. Observational studies were searched for in MEDLINE, EMBASE and the Cochrane Central Register. Thirty‐seven observational studies with a total of 29 557 study participants were identified. This study was performed according to the Preferred Reporting Items for Systematic reviews and Meta‐Analyses (PRISMA) 2020 checklist and quality was assessed via the Newcastle‐Ottawa Quality Assessment Scale., Overall prevalence of facial dermatoses was 55%. Individually, acne, facial dermatitis, itch and pressure injuries were consistently reported as facial dermatoses, with a pooled prevalence of 31%, 24%, 30% and 31%, respectively. Duration of mask‐wear was the most significant risk factor for the development of facial dermatoses (95% CI: 1.31–1.54, p < 0.001). Overall, facial dermatoses associated with mask wear are common, and consist of distinct entities. They are related to duration of use. Appropriate and tailored treatment is important to improve the outcomes for these affected patients.
Background
Nail involvement is not well‐studied in atopic dermatitis but is believed to be more common than what is known. The spectrum of nail disorders that result from underlying atopic dermatitis ...(AD) is wide and has been reported in several studies, but there has been no systematic review so far to understand and quantify its prevalence.
Objective
To determine the prevalence and type of nail disorders seen in AD, either as a complication of the underlying condition or as a clue to its early diagnosis.
Methods
The authors performed a systematic review of English and non‐English articles using MEDLINE, EMBASE, and Cochrane which reported the proportion of nail changes among AD patients. Only studies specifically looking at AD and its associated nail manifestations were included. Data were extracted and summarized descriptively.
Results
Twelve studies reported proportion of nail changes among AD patients. One study reported numbers in both adults and children cohorts, allowing 13 cohorts for final systematic review.
Conclusions
Knowledge of the types and prevalence of nail changes in AD raises awareness among physicians managing AD.
Background
Although the traditional understanding is that contact sensitization is less frequent in patients with atopic dermatitis (AD), recent studies have shown similar or higher rates of positive ...patch‐test results in AD patients.
Objectives
We sought to characterise the pattern of contact sensitization in patients with and without AD and evaluate the association between AD and contact sensitization.
Method
This was a single‐center, 10‐year retrospective review of patients who underwent patch testing between 2007 and 2017.
Results
There were 4903 patients (male‐to‐female ratio = 1:1.4; mean age 40.1 years) included. About half (2499, 51.0%) of all patients developed at least one positive reaction. The top five frequent reactions were to nickel sulfate (45.4%), potassium dichromate (16.0%), p‐phenylenediamine (13.4%), Myroxylon pereirae (11.8%), and fragrance mix I (11.2%). The overall prevalence of contact sensitization was not significantly different between patients with or without AD. Patients with AD were less likely to develop contact allergies to budesonide and thiuram mix, and more likely to develop contact allergies to potassium dichromate.
Conclusions
Contact sensitization was detected in 50% of patients who were patch tested. Nickel sulfate was the most frequently sensitizing allergen. The prevalence of contact allergies in atopic patients is comparable to that in non‐atopic patients.
Retrospective review of the pattern of contact sensitisation in patients in an Asian dermatology center.
Development or exacerbation of head and neck dermatitis (HN‐D) in association with dupilumab has been reported. Severity of HN‐D varies, and may persist even with discontinuation of dupilumab. ...Development or exacerbation of HN‐D is not yet completely understood, and various hypotheses have been made about the possible underlying pathophysiology. To date, there is no established treatment for HN‐D in association with dupilumab. We report 2 cases of HN‐D occurring following dupilumab treatment, with significant improvement of HN‐D following treatment with abrocitinib.
Population studies suggest that atopic dermatitis (AD) is associated with an increased risk of obesity, however a causal relationship between these two conditions remains to be established. We ...therefore use Mendelian randomization (MR) to evaluate whether obesity and AD are causally interlinked. We used summary statistics extracted from genome wide association studies of Body Mass Index (BMI) and AD. MR analysis was performed in both directions to establish the direction of causality between BMI and AD. We find that genetically determined increase in adiposity is associated with increased risk of AD (odds ratio of AD 1.08 95% CI 1.01 to 1.14; p = 0.015 per unit increase in BMI). Conversely, genetically determined increased risk of AD is not associated with a higher BMI (change in BMI attributable to AD based on genetic information: 0.00; 95% CI - 0.02 to 0.02; p = 0.862). There was no evidence for confounding of these genetic analyses by horizontal pleiotropy. Our results indicate that the association of AD with obesity is likely to reflect a causal role for adiposity in the development of AD. Our findings enhance understanding of the etiology of AD, and the basis for experimental studies to evaluate the mechanistic pathways by which adiposity promotes AD.
Atopic eczema onset is described primarily in early childhood, and the frequency and characteristics of adult-onset disease remain controversial.
We sought to determine the proportion of subjects who ...report atopic eczema symptoms between birth and midadulthood and to examine demographic, immunologic, and genetic factors associated with period of symptom onset.
We conducted a longitudinal study using data from 2 nationally representative community-based birth cohorts from the United Kingdom: the British Cohort Studies 1958 and 1970. Subjects were followed from birth through age 42 to 50 years. The primary outcome was the age period of self-reported atopic eczema symptom onset based on repeated measures of self-reported atopic eczema at each survey wave.
The annual period prevalence of atopic eczema ranged from 5% to 15% in 2 cohorts of more than 17,000 participants each followed from birth through middle age. There was no clear trend in prevalence by age, and among adults reporting active atopic eczema during a given year, only 38% had symptom onset reported in childhood. When compared with subjects whose eczema started in childhood, those with adult-onset disease were more likely to be women, from Scotland or Northern England, of lower childhood socioeconomic group, smokers in adulthood, and less likely to have a history of asthma. In a subanalysis using data from the 1958 cohort only, genetic mutations previously associated with atopic eczema, including filaggrin-null mutations, and allergen-specific IgE were more common among those with childhood-onset disease.
Rates of self-reported atopic eczema remain high after childhood, and adult-onset atopic eczema has different risk factor associations than childhood-onset eczema.
Display omitted
Head and neck atopic dermatitis (HNAD) is a subtype of atopic dermatitis (AD), a common inflammatory skin condition with a distinctive clinical appearance. Malassezia spp., a predominant skin yeast, ...is considered to exacerbate HNAD. In this study, we investigate the prevalence of Malassezia‐specific IgE among HNAD patients. A comprehensive search was performed for observational studies analysing the association between Malassezia‐specific IgE and HNAD. This study was performed according to the Preferred Reporting Items for Systematic reviews and Meta‐Analyses 2020 checklist and quality was assessed via the Newcastle‐Ottawa Quality Assessment Scale (NOS). Fourteen observational studies (840 patients) were included in the analysis. 58% of HNAD patients were male (95% CI: 45.2–69.7). Overall prevalence of Malassezia‐specific IgE among HNAD patients was 79.3% (95% CI: 57.5–91.5). Prevalence of Malassezia‐specific IgE among HNAD patients varied significantly between geographical regions (p = 0.0441), with 88% in non‐Asian regions (95% CI: 61.06–97.17) and 54.73% in Asian regions (95% CI: 34.36–73.63). Malassezia‐specific IgE prevalence among HNAD patients varied significantly among studies of higher and lower NOS quality score (p = 0.0386), with 95.42% in studies with NOS ≥7 (95% CI: 63.54–99.60) and 58.05% in studies with NOS <7 (95% CI: 41.44–73.01). Malassezia‐specific IgE prevalence among HNAD patients did not vary significantly between more and less predominant Malassezia species (p = 0.1048). Malassezia spp. plays a crucial role in the pathogenesis of HNAD, and IgE anti‐Malassezia antibodies appeared to be a common marker for HNAD. Understanding the pathophysiology of Malassezia in HNAD can help develop more targeted therapeutic approaches in managing AD.
Malassezia plays a crucial role in the pathogenesis of head and neck atopic dermatitis (HNAD), and IgE anti‐Malassezia antibodies appeared to be a common marker for HNAD. Overall prevalence of Malassezia‐specific IgE among HNAD patients was 79.3%.
While it is well established that skin disease places significant psychosocial burden on a patient's wellbeing, its effects have rarely been examined in Asian populations.
Evaluate the psychosocial ...burden of skin disease among community-dwelling adults in Singapore.
This cross-sectional study included 1510 participants interviewed on their history of thirteen skin diseases. The Patient Health Questionnaire (PHQ-9), Lubben Social Network Scale-6 (LSNS-6), University of California Los Angeles (UCLA) Loneliness Scale, and European Quality of Life-5 Dimensions- 5 Level (EQ-5D-5L) were used as measures for depressive symptoms, social isolation, loneliness and quality of life respectively. Multiple linear regression analysis was used to examine the association of skin diseases with each of the four measured outcomes.
Participants with skin diseases reported significantly higher PHQ-9 and UCLA Loneliness scale scores, and lower LSNS-6 and EQ-5D-5L scores when compared to their healthy counterparts. The presence of skin disease was positively associated with depressive symptoms (B = 0.40, SE = 0.11), and negatively associated with quality of life (B = -0.03, SE = 0.01). As disease severity was not evaluated in this study, we were unable to ascertain the associations between disease severity and measured outcomes.
Participants with skin diseases were more likely to have depressive symptoms, social isolation, loneliness and lower quality of life. Unemployed, single and elderly patients were at higher risk of developing depressive symptoms. More emphasis should be placed on the psychosocial aspect of care to reduce the burden of skin disease. Some considerations include monitoring patients for mood-related changes and implementing early psychosocial interventions.
PDF
