Atopic Hand Eczema

Abstract

Atopic dermatitis (AD) is an allergic, inflammatory skin disorder, characterized by itching and relapsing dermatitis. The lesional skin is occupied by increased numbers of T cells, eosinophils, and mast cells, and while the acute phase of the inflammatory response in the skin is dominated by Th2 cells, in the chronic phase Th1 cells start to take over. Genetic factors play an important role in the onset of atopic dermatitis, and polymorphism in the genes controlling either skin barrier function or adaptive and innate immune responses has been shown to associate with AD in several studies. However, the rapid increase of this disease indicates that environmental factors also play a crucial role. Evidence suggests that reduced microbial exposure due to urbanization, improved hygiene, and efficient health-care measures may account for increased rates of allergic diseases such as AD. The diagnosis of atopic hand dermatitis assumes the fact that the patient has atopic dermatitis, where the major criteria for diagnosis are pruritus and, additionally, typical clinical features. Treatment of atopic hand dermatitis contains avoidance of irritants and possible allergens and use of emollients, topical corticosteroids, and topical calcineurin inhibitors.