The association between atopic dermatitis and hand eczema: a systematic review and meta-analysis

S. M.D. Ruff, K. A. Engebretsen, C. Zachariae, J. D. Johansen, J. I. Silverberg, A. Egeberg, J. P. Thyssen*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

49 Scopus citations


Background: Atopic dermatitis (AD) and hand eczema (HE) are common chronic and relapsing inflammatory skin conditions that often co-occur. Objectives: While several studies have addressed their relationship, the exact association estimate is unknown. Methods: We systematically reviewed published literature on the association between AD and HE in PubMed, Embase and Web of Science using the following search terms: (atopic dermatitis OR atopic eczema) AND (hand dermatitis OR hand eczema). Meta-analyses were then performed to examine the association between AD and the point, 1-year and lifetime prevalence of HE, respectively. Results: We identified 35 relevant studies, of which 26 were included in the meta-analyses. AD was associated with an increased prevalence of HE with regard to point [odds ratio (OR) 2·35; 95% confidence interval (CI) 1·47–3·76], 1-year (OR 4·29; 95% CI 3·13–5·88) and lifetime prevalence (OR 4·06; 95% CI 2·72–6·06). Furthermore, positive associations between AD and occupational HE were identified when assessing the 1-year (OR 4·31; 95% CI 2·08–8·91) and lifetime prevalence (OR 2·81; 95% CI 2·08–3·79). Similar positive associations were found in the general population studies, i.e. OR 4·19 (95% CI 3·46–5·08) and OR 5·69 (95% CI 4·41–7·36). Conclusions: Important study limitations include the wide use of questionnaire studies, and lack of prospective studies as well as poor clinical phenotype descriptions. In conclusion, our systematic review and meta-analysis showed that patients with AD had a strongly increased prevalence of HE. Clinicians should continue to guide patients with AD away from occupations with a high risk of HE.

Original languageEnglish (US)
Pages (from-to)879-888
Number of pages10
JournalBritish Journal of Dermatology
Issue number4
StatePublished - Apr 2018

ASJC Scopus subject areas

  • Dermatology


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