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Nichtallergische Komorbiditäten bei atopischer Dermatitis

Nonallergic comorbidities of atopic dermatitis

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Zusammenfassung

Hintergrund

Die Berücksichtigung des gesamten Spektrums nichtallergischer Komorbiditäten der atopischen Dermatitis (AD) ist für eine adäquate, patientenzentrierte Versorgung erforderlich.

Ziel der Arbeit

Auf der Grundlage systematischer Reviews (SRs) und aktueller Fallkontrollstudien wird die Evidenz bezüglich nichtallergischer Komorbiditäten der AD zusammengefasst.

Material und Methoden

Eine umfassende systematische Literaturrecherche wurde in den Datenbanken Medline und Embase (Suchzeitraum: bis 15.11.2014) durchgeführt.

Ergebnisse

Insgesamt wurden 9 SRs eingeschlossen. Basierend auf 6 SRs, die den Zusammenhang zwischen AD und Krebserkrankungen untersuchten, konnten verminderte Risiken für das Auftreten von Gliomen, Meningiomen und akuter lymphatischer Leukämie bei Patienten mit vorausgegangener AD festgestellt werden. Gleichfalls konsistente positive Assoziationen fanden sich in 1 SR bezüglich AD und Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung. Hingegen zeigen 2 SRs mit Fokus auf Diabetes mellitus Typ 1 und multipler Sklerose, dass derzeit keine Evidenz für einen Zusammenhang mit AD vorliegt. Eine weiterführende Sichtung einzelner Beobachtungsstudien zu immunologischen und psychiatrischen Erkrankungen verdeutlicht, dass AD ein signifikanter Risikofaktor für Morbus Crohn, affektive sowie schizophrene Störungen und Verhaltensstörungen zu sein scheint.

Schlussfolgerung

Weiterführende Längsschnittstudien sind notwendig, um das Vorliegen kausaler Zusammenhänge zu überprüfen. Genetische und physiologische Wirkmechanismen der geschilderten Zusammenhänge sollten in interdisziplinären Arbeitsgruppen untersucht werden.

Abstract

Background

Recognizing the whole spectrum of comorbidities related to atopic dermatitis (AD) is prerequisite for adequate, patient-centered care.

Objectives

Based on systematic reviews (SRs) and published case–control studies, the current evidence on nonallergic comorbidities of AD is summarized.

Materials and methods

A comprehensive systematic literature search was performed in Medline and Embase (Search period: through 15 November 2014).

Results

In total, nine systematic reviews were included. Six reviews investigating the association between AD and cancer suggested a decreased risk of glioma, meningioma, and acute lymphoblastic leukemia in patients with current or previous AD. One SR reported a consistent positive association of AD with attention deficit hyperactivity disorder. In comparison, two SRs focusing on the relationship between AD and diabetes mellitus type 1 and multiple sclerosis showed that there is no evidence supporting an association. A further screening of individual observational studies concerning immunological and psychiatric diseases pointed out that AD seems to be a significant risk factor for Crohn’s disease, affective, schizophrenic, and behavior disorders.

Conclusion

Further longitudinal studies are needed to verify the existence of causal relationships. Interdisciplinary working groups are desirable to investigate explanations for genetic and physiologic mechanisms of described associations between AD and nonallergic comorbidities.

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Authors and Affiliations

  1. Zentrum für Evidenzbasierte Gesundheitsversorgung (ZEGV), Medizinische Fakultät Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland

    S. Deckert &  J. Schmitt MPH

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Correspondence to J. Schmitt MPH.

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Interessenskonflikt

S. Deckert und J. Schmitt geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Deckert, S., Schmitt, J. Nichtallergische Komorbiditäten bei atopischer Dermatitis. Hautarzt 66, 103–107 (2015). https://doi.org/10.1007/s00105-014-3568-7

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