TY - JOUR

T1 - Association of atopic dermatitis with smoking

T2 - A systematic review and meta-analysis

AU - Kantor, Robert

AU - Kim, Ashley

AU - Thyssen, Jacob P

AU - Silverberg, Jonathan I

N1 - Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

PY - 2016/12

Y1 - 2016/12

N2 - BACKGROUND: Tobacco exposure might be a modifiable risk factor for atopic dermatitis (AD).OBJECTIVE: We examine the association between AD and exposure to tobacco smoke.METHODS: We performed a systematic review and meta-analysis of observational studies (n = 86) in MEDLINE, EMBASE, Scopus, and Cochrane Library (1823-2015). Quality of evidence was assessed using the Newcastle-Ottawa Scale (NOS). A meta-analysis was performed using random-effects models to estimate pooled odds ratios (OR). Subset analyses were performed for different ages (children, adult), regions, study designs (cross-sectional, longitudinal), study sizes (<5000, ≥5000), study quality (NOS score <6, ≥6), and amount of smoking (mild, extensive).RESULTS: A diagnosis of AD was associated with higher odds of active smoking (OR 1.87, 95% confidence interval 1.32-2.63) and exposure to passive smoke (OR 1.18, 95% confidence interval 1.01-1.38), but not maternal smoking during pregnancy (OR 1.06, 95% confidence interval 0.80-1.40). The association between active smoking and AD remained significant in children and adults, all continents studied, and study sizes, but all were cross-sectional designs and had NOS score 6 or greater. Passive smoke was associated with AD in children and adults, cross-sectional studies, South/Central American and African studies, study size less than 5000, and NOS score less than 6.LIMITATIONS: AD severity and distribution were not assessed.CONCLUSIONS: Active and passive exposure to smoke are associated with increased AD prevalence.

AB - BACKGROUND: Tobacco exposure might be a modifiable risk factor for atopic dermatitis (AD).OBJECTIVE: We examine the association between AD and exposure to tobacco smoke.METHODS: We performed a systematic review and meta-analysis of observational studies (n = 86) in MEDLINE, EMBASE, Scopus, and Cochrane Library (1823-2015). Quality of evidence was assessed using the Newcastle-Ottawa Scale (NOS). A meta-analysis was performed using random-effects models to estimate pooled odds ratios (OR). Subset analyses were performed for different ages (children, adult), regions, study designs (cross-sectional, longitudinal), study sizes (<5000, ≥5000), study quality (NOS score <6, ≥6), and amount of smoking (mild, extensive).RESULTS: A diagnosis of AD was associated with higher odds of active smoking (OR 1.87, 95% confidence interval 1.32-2.63) and exposure to passive smoke (OR 1.18, 95% confidence interval 1.01-1.38), but not maternal smoking during pregnancy (OR 1.06, 95% confidence interval 0.80-1.40). The association between active smoking and AD remained significant in children and adults, all continents studied, and study sizes, but all were cross-sectional designs and had NOS score 6 or greater. Passive smoke was associated with AD in children and adults, cross-sectional studies, South/Central American and African studies, study size less than 5000, and NOS score less than 6.LIMITATIONS: AD severity and distribution were not assessed.CONCLUSIONS: Active and passive exposure to smoke are associated with increased AD prevalence.

KW - Africa

KW - Age Factors

KW - Asia

KW - Central America

KW - Cross-Sectional Studies

KW - Dermatitis, Atopic

KW - Europe

KW - Female

KW - Humans

KW - North America

KW - Pregnancy

KW - Risk Factors

KW - Smoking

KW - South America

KW - Tobacco Smoke Pollution

KW - Journal Article

KW - Meta-Analysis

KW - Review

U2 - 10.1016/j.jaad.2016.07.017

DO - 10.1016/j.jaad.2016.07.017

M3 - Review

C2 - 27542586

VL - 75

SP - 1119-1125.e1

JO - American Academy of Dermatology. Journal

JF - American Academy of Dermatology. Journal

SN - 0190-9622

IS - 6

ER -