Department of Dermatology, Paul Sabatier University, Toulouse, France.
Department of Rheumatology, Bordeaux University Hospital, Bordeaux, France.
J Am Acad Dermatol. 2015 Jun;72(6):992-1002. doi: 10.1016/j.jaad.2015.02.1116. Epub 2015 Apr 1.
There is controversy regarding a potential increased risk of lymphoma in patients with atopic dermatitis (AD).
To assess the risk of lymphoma and the role of topical treatments in patients with AD.
A systematic literature search and a separate meta-analysis were performed on case control and cohort studies.
Of the 3979 articles retrieved, 24 references met the inclusion criteria. In cohort studies, the risk of lymphoma was slightly increased, with a relative risk (RR) of 1.43 (95% confidence interval [CI], 1.12-1.81). In case control studies, no significant increased risk of lymphoma was found, with an odds ratio (OR) of 1.18 (95% CI, 0.94-1.47). Severity of AD was a significant risk factor. Highly potent topical steroids were associated with an increased risk of lymphoma. For topical calcineurin inhibitors (TCIs), a significant association between tacrolimus and mostly skin lymphoma was found in 1 study.
Confusion between severe AD and cutaneous T-cell lymphoma may account for part of the increased risk of lymphoma in patients with AD.
This systematic literature review shows a slightly increased risk of lymphoma in patients with AD. Severity of AD appears to be a significant risk factor. The role of topical steroids and TCIs is unlikely to be significant.
特应性皮炎（AD）患者的淋巴瘤风险是否增加存在争议。
评估 AD 患者发生淋巴瘤的风险以及局部治疗的作用。
对病例对照和队列研究进行了系统的文献检索和单独的荟萃分析。
在检索到的 3979 篇文章中，有 24 篇参考文献符合纳入标准。在队列研究中，淋巴瘤的风险略有增加，相对风险（RR）为 1.43（95%置信区间 [CI]，1.12-1.81）。在病例对照研究中，未发现淋巴瘤的风险显著增加，比值比（OR）为 1.18（95% CI，0.94-1.47）。AD 的严重程度是一个显著的危险因素。强效局部皮质类固醇与淋巴瘤风险增加相关。对于局部钙调神经磷酸酶抑制剂（TCIs），在 1 项研究中发现他克莫司与皮肤淋巴瘤之间存在显著关联。
严重 AD 与皮肤 T 细胞淋巴瘤之间的混淆可能是 AD 患者淋巴瘤风险增加的部分原因。
本系统文献回顾显示 AD 患者的淋巴瘤风险略有增加。AD 的严重程度似乎是一个显著的危险因素。局部皮质类固醇和 TCIs 的作用可能并不显著。
