Bilateral Association Between Atopic Dermatitis and Alopecia Areata: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis aimed to explore the association between atopic dermatitis (AD) and alopecia areata (AA). A comprehensive search was conducted in PubMed, Embase, Cochrane, and Web of Science from the inception of each database to November 10, 2022 for relevant studies. As there is a potential bilateral association between the 2 diseases, we assessed the prevalence/incidence of AA in patients with AD and the prevalence/incidence of AD in patients with AA. A total of 29 studies involving 11,233,448 participants were included in this analysis. AA was the exposure factor in 23 studies, AD in 7 studies, and both in 1 study. The meta-analysis revealed that the prevalence of AD was 11.2% (7.7%-15.1%) in patients with AA, and the prevalence of AA was 3.2% (95% confidence interval [CI]: 0.0%-11.5%) in patients with AD. The incidence of AD in AA patients was found to vary with age (P = 0.07). Based on 7 studies, there was a significant association between AD and AA when AA was the exposure factor [odds ratio, OR, = 4.537 (95% CI: 2.409-8.544)]; based on 10 studies, there was also a significant association between AD and AA when AD was the exposure factor [OR = 2.643 (95% CI: 1.737-3.995)]. In conclusion, this meta-analysis demonstrated the 2-way association between AD and AA, providing a clinical reference for disease prevention and control.

Automated summary

This systematic review and meta-analysis examined the association between atopic dermatitis (AD) and alopecia areata (AA). Through a comprehensive search, 29 studies with a total of 11,233,448 participants were included in the analysis. The meta-analysis showed that the prevalence of AD in patients with AA was 11.2% and the prevalence of AA in patients with AD was 3.2%. Age was found to affect the incidence of AD in AA patients. There was a significant association between AD and AA when AA was the exposure factor, as well as when AD was the exposure factor. This study provides important clinical reference for disease prevention and control.