Association Between Atopic Dermatitis and Contact Sensitization: An Updated Systematic Review and Meta-Analysis

Whether atopic dermatitis (AD) is associated with an altered susceptibility to contact sensitization (CS) remains debated. The aim of this systematic review and meta-analysis was to provide updated estimates of the association between AD and CS overall, by population type (general or referred), various demographics and selected allergens. PubMed, Embase and Web of Science were systematically searched for studies published between 2016 and 2025 reporting CS prevalence in individuals with and without AD. Data were combined with a previous systematic review covering studies published between 1982 and 2016. Meta-analyses were performed to calculate pooled odds ratios (ORs). The pooled analyses showed no overall association between AD and CS (OR 1.08, 95% CI: 0.82-1.42), including in referred populations (OR 1.03, 95% CI: 0.76-1.38). In general population studies, CS prevalence was higher among individuals with AD. The association was statistically significant in children and adolescents (OR 1.34, 95% CI: 1.0-1.80) but not in adults. Positive associations were found between AD and CS to Compositae mix and sesquiterpene lactone mix, but not to nickel, cobalt, or chromium. In conclusion, our findings suggest no general association between AD and contact CS, but multiple factors may modify this relationship, underlining the value of patch testing in AD.