Chronic hand eczema: clinical characterization, aetiology, concomitant foot eczema and polysensitization.

Abstract

Chronic hand eczema (CHE) is a disabling dermatosis that presents with concomitant conditions, such as foot eczema and contact sensitization To identify the characteristics of the CHE population, with particular emphasis on occupational relevance and evaluation of concomitant foot eczema and polysensitization A total of 2,926 patch-tested patients, presenting with CHE from different specialized dermatological units from 2004 to 2014, were evaluated. A global descriptive characterization was performed including hand subtype analysis, as well as accurate evaluation of polysensitization The most frequent global CHE diagnostic was irritant contact dermatitis (42%) and, for patients with foot and chronic hand eczema (FCHE), allergic contact dermatitis (28%). Of CHE cases, 39% showed occupational relevance. Positivity to at least one allergen was found in 55% of patients, with nickel and methylisothiazolinone (MI) being the most prevalent. Methylchloroisothiazolinone/MI, nickel and potassium dichromate showed the highest occupational relevance. Patients with concomitant FCHE (8%) showed greater sensitization for potassium dichromate and cobalt chloride. Twelve percent were polysensitized, with MI being the most frequently involved contact allergen Patch testing for FCHE and CHE revealed a specific contact allergen and occupational profile. MI was the most frequently reported allergen related to polysensitization in CHE.