Exploring the link between atopic dermatitis and allergic contact dermatitis in patients with skin of color: a scoping review

Background: Patients with skin of color (SOC) experience increased rates of atopic dermatitis (AD) than the general population and suffer from more severe disease. In addition, patients with SOC experience higher sensitization rates to particular allergens and are patch tested less frequently. Because of these factors, there is a need to assess whether allergic contact dermatitis (ACD) contributes to the higher disease severity in SOC patients with AD. Objective: The goal of this review is to systematically evaluate the potential association between ACD and AD in the SOC population. Methods: A systematic search of PubMed (date of last search: July 2025) was performed to identify studies of patients with SOC referred for patch testing to various allergens for suspected ACD. AD prevalence and clinical outcomes were required for inclusion. Data collected and provided in table format included: author, type and year of study, race/ethnicity of subjects, eczema prevalence, patch test positivity, specific allergen sensitivities, and allergen source. Results: Four out of the 8 manuscripts meeting inclusion criteria provided evidence for a higher eczema prevalence in patients with SOC who were referred for patch testing; however, larger, well-designed studies are required to fully elucidate the true associations among patients with SOC, AD, and ACD. Limitations: The limited number and heterogeneity of studies and the potential underreporting of both ACD and AD in patients with SOC may contribute to potential bias. Further, this is a scoping review and does not provide additional data analysis to support any particular conclusion. Conclusion: Dermatologists must continue to counsel SOC patients with AD regarding potential disease-modifying ACD-related exposures.