Cases Of Hand Eczema Research Articles

Incidence Rate of Hand Eczema in Different Occupations: A Systematic Review and Meta-analysis.

Hand eczema is a chronic disease that results in economic and psychosocial burdens. The aim of this study was to systematically review and assess the magnitude of the association between exposure related to occupations and the incidence rate of hand eczema. A systematic search in PubMed, EMBASE, CINAHL and Cochrane databases, from inception to September 2017, of full-text observational studies reporting incident cases of hand eczema during employment, and a supplementary search in PubMed to September 2020, were conducted. Among 2,417 screened abstracts, 15 studies fulfilled the inclusion criteria. Incidence rates were reported per 100 person-years. Based on the Newcastle-Ottawa Scale, 9 studies were good quality, 2 fair quality, and 4 poor quality. Hairdressers had a high incidence of hand eczema of 21.4 (95% confidence interval [CI] 15.3-27.4), as did nurses, 16.9 (95% CI 11.2-22.7), and metal workers, 12.4 (95% CI 3.5-21.3). Hairdressers were predominantly women, and metal worker were predominantly men. Office occupations had an incidence rate of hand eczema of 4.9 (95% CI 1.2-9.6). The high risk of hand eczema for hairdressers, nurses, and metal workers, should be considered by healthcare policymakers. Even occupations with low irritant profile, such as office workers, were at risk of developing hand eczema, and more occupations should be investigated regarding the related risk of developing hand eczema.

Incidence Rate of Hand Eczema in Different Occupations: A Systematic Review and Meta-analysis.

Hand eczema is a chronic disease that results in economic and psychosocial burdens. The aim of this study was to systematically review and assess the magnitude of the association between exposure related to occupations and the incidence rate of hand eczema. A systematic search in PubMed, EMBASE, CINAHL and Cochrane databases, from inception to September 2017, of full-text observational studies reporting incident cases of hand eczema during employment, and a supplementary search in PubMed to September 2020, were conducted. Among 2,417 screened abstracts, 15 studies fulfilled the inclusion criteria. Incidence rates were reported per 100 person-years. Based on the Newcastle-Ottawa Scale, 9 studies were good quality, 2 fair quality, and 4 poor quality. Hairdressers had a high incidence of hand eczema of 21.4 (95% confidence interval [CI] 15.3-27.4), as did nurses, 16.9 (95% CI 11.2-22.7), and metal workers, 12.4 (95% CI 3.5-21.3). Hairdressers were predominantly women, and metal worker were predominantly men. Office occupations had an incidence rate of hand eczema of 4.9 (95% CI 1.2-9.6). The high risk of hand eczema for hairdressers, nurses, and metal workers, should be considered by healthcare policymakers. Even occupations with low irritant profile, such as office workers, were at risk of developing hand eczema, and more occupations should be investigated regarding the related risk of developing hand eczema.

Smoking Habit and Correlation with Hand Eczema in Healthcare Workers in the Time of COVID-19

Abstract Background: Hand eczema, in time of COVID-19, is one of the most frequently diagnosed skin disorders in nurses. In this study, we sought to investigate whether smoking could be an additional risk factor for hand eczema in nurses during the COVID-19 pandemic. Method: Using a questionnaire about smoking details and hand eczema, we conducted a study among nurses involved in the frontline management of COVID-19 patients. A total of 1,000 questionnaires were sent out. The questionnaires were anonymous and based on self-reported answers, with no clinical examination or medical data evaluation. All nurses enrolled in the study were women, working in shifts for the last three months since the start of the COVID-19 pandemic. Results: Two-hundred forty-seven questionnaires were accepted for the study, after eliminating non-responders and nurses without hand eczema. The majority of nurses denied smoking (87.85%) in the past and at the moment of the study. Statistics related to years of smoking and occurrence of hand eczema showed no increase in the number of cases in correlation with the number of years of smoking. Similarly, a random distribution of cases of hand eczema was observed when compared to the number of cigarettes per day. Conclusion: Our data does not support the hypothesis that smoking is an independent risk factor for the development of occupational hand eczema during the COVID-19 pandemic.

The "dermatologist's procedure" after the abolition of the obligation to refrain from risky work activities in occupational disease law

Die Berufskrankheit (BK) Haut Nr. 5101 war bisher definiert als „schwere oder wiederholt rückfällige Hauterkrankungen, die zur Unterlassung aller Tätigkeiten gezwungen haben, die für die Entstehung, die Verschlimmerung oder das Wiederaufleben der Krankheit ursächlich waren oder sein können“. In einer weitreichenden Reform des Berufskrankheitenrechts, die zum 01.01.2021 in Kraft trat, hat der Gesetzgeber beschlossen, den „Unterlassungszwang“ als Voraussetzung für die Anerkennung einer Berufskrankheit abzuschaffen. Dieser Unterlassungszwang sollte mit dem 1972 eingeführten Hautarztverfahren und den dort etablierten Präventionsinstrumenten (dermatologische Behandlung, Sanierung des Arbeitsplatzes, Hautschutzmaßnahmen, gesundheitspädagogische Maßnahmen) verhindert werden, was in einem Großteil der Fälle auch gelang. Während die Abschaffung des Unterlassungszwangs die Anerkennung von schweren oder wiederholt rückfälligen Hauterkrankungen als Berufskrankheiten erleichtert, wird das Hautarztverfahren jedoch weiterhin Bedeutung behalten für die beruflichen Hauterkrankungen, insbesondere Handekzeme, die primär nicht die Kriterien der Schwere und/oder der wiederholten Rückfälligkeit erfüllen und die durch geeignete Behandlungs- und Präventionsmaßnahmen beherrscht werden können. Um bei einer BK-Anzeige wegen der Schwere oder wiederholten Rückfälligkeit einer Hauterkrankung Verzögerungen in der Sekundärprävention zu vermeiden, sollte gleichzeitig über einen Hautarztbericht zur BK-Anzeige der Unfallversicherungsträger die für zeitnahe Präventionsmaßnahmen und einen dermatologischen Behandlungsauftrag erforderlichen Informationen erhalten. Ein Anhaltspunkt für die Schwere könnte der Erfolg oder der Misserfolg des Hautarztverfahrens sein.

Hand Hygiene Practices and Risk and Prevention of Hand Eczema during the COVID-19 Pandemic.

Hand Hygiene Practices and Risk and Prevention of Hand Eczema during the COVID-19 Pandemic.

Prevalence and pattern of hand eczema in a tertiary referral hospital of Nepal

Background: Hand eczema is a very common condition that has a significant effect on an individual’s life in terms of daily functioning including various occupations. Studies show that the point prevalence of hand eczema is around 4% and the lifetime prevalence is 15%.
 Objective: The objective of this study is to determine the prevalence and pattern of hand eczemas in patients attending the Dermatology outpatient department of Bir hospital.
 Materials and methods: This is a retrospective study, where all the cases of hand eczema who presented to the Dermatology Out-Patient Department of Bir Hospital during the period from Baisakh 2075 till Chaitra 2075 B.S were recorded.
 Results: Eczema was diagnosed in 5,100 new cases (15.74%) and among them, hand eczema was seen in 494 cases, which accounts for 9.68% of all eczemas. The mean age was 37.43 years. Out of all the hand eczemas recorded, 334 (67.6%) were unspecified hand eczemas, pompholyx was seen in 92 (18.6%) cases, chronic hand eczema in 27 (5.5%), contact dermatitis in 20 (4%) patients and finger tip eczema was seen in 15 (3%) cases.
 Conclusion: Hand eczema is one of the common dermatological conditions. Our study showed the prevalence of hand eczema to be 9.68%.

Study of clinical profile and association of severity with contact sensitivity of hand eczema patients

<p class="abstract"><strong>Background:</strong> This present study was to evaluate the clinical profile, severity and its pattern as well as association between contact sensitivity with its severity in hand eczema patients.</p><p class="abstract"><strong>Methods:</strong> A detailed demographic profile, occupation, history regarding onset of disease, duration, progress of hand dermatitis, aggravating and relieving factors, seasonal variations, presence of atopy in self or family, day to day work, hobbies, and past and present treatment were performed to all cases of hand eczema. Severity of hand eczema was assessed by using hand eczema severity index (HECSI). Patch test was applied to all cases with standard Indian patch test battery as approved by contact dermatitis and occupational dermatoses forum of India. Data was applied by using SPSS version 26 software. P value was taken equal to or less than 0.05 for significant differences.</p><p class="abstract"><strong>Results:</strong> Hand eczema was commonly seen in male and middle age group (31-45 years) patients. Masons, house wives and farmers were mostly infected with hand eczema. Hyperkeratotic eczema and wear and tear dermatitis were the most common type of hand eczema. Potassium dichromate and nickel were the most common antigen/allergens. HECSI score 40-60 was seen in majorities of hand eczema cases. And there was no statistical significant association seen in between severity and positive patch test sensitivity in patients with hand eczema.</p><p class="abstract"><strong>Conclusions:</strong> Works associated with exposure to various chemical agents are at higher risk for developing hand eczema. Our study will of immense help to patients for identification of contact sensitizer and prevention from hand eczema.</p>

Patch Test as a Diagnostic Tool in Hand Eczema.

Allergic contact dermatitis is an important cause of hand eczema. Patch testing is the only investigation available to prove the diagnosis of allergic contact dermatitis. Exposures to allergens differ according to geographical, occupational, economic and social factors. Accordingly, patterns of allergic contact dermatitis differ in different parts of the world and different regions of the same country. To study the causes of allergic contact dermatitis in adult patients with hand eczema with the help of patch testing. This was a cross-sectional study involving 54 hand eczema patients conducted between October 2013 and June 2015, at a tertiary care centre in Southern India. After a detailed history including history of occupational exposure and detailed examination, patch test was done on these patients with Indian standard series. The patches were removed after 48 hours. Another reading was taken after 72 hours. The readings were interpreted according to International Contact Dermatitis Research Group criteria and noted down. The data were summarized using mean and standard deviation for continuous variables and percentages for categorical and dichotomous variables. The test of association was done with Fisher's-exact test. Hyperkeratotic hand eczema was the commonest morphological type (29%), followed by discoid eczema. Pompholyx was significantly more common among patients with history of atopy. A total of 20 patients (37%) showed patch test positivity to a total of 25 allergens. Nickel was the most common allergen (11.11%) followed by para-phenylenediamine (PPD) (7.4%). Nickel (6 patients) and cobalt (3 patients) were the common allergens among women, while potassium dichromate (3 patients) and parthenium (2 patients) were the common allergens among men. Potassium dichromate allergy was significantly more common among masons and PPD allergy was significantly more common among hair dye users. Discoid pattern of hand eczema was common among patients with allergy to potassium dichromate. Majority of the cases of hand eczema are not due to allergic contact dermatitis. History of atopy is common among patients with pompholyx. Allergic contact dermatitis due to nickel remains a common cause of hand eczema.

Outbreak of eczema and rhinitis in a group of office workers in Greenland

IntroductionDisturbed indoor climate may in some cases be associated with illness. In the present paper, we report the results from a thorough investigation of office workers in Greenland, who developed skin and/or airway problems after moving into renewed offices.Material and methodsIn 2009 the office of the Bank of Greenland had a total renovation of the building, including new furniture and carpets. Symptoms developed within the first year after moving back into the renewed buildings. After removal of carpets in the building, symptoms significantly improved. Workers were examined in 2009 and re-examined in 2013, including clinical examination, patch test and when relevant also skin prick tests and histamine release test. Isothiazolinones and fumarates, both able to cause airway as well as skin symptoms, were isolated from carpets before testing, and included in the test series.ResultsIn total, 32 out of 80 workers (40%) developed symptoms; 27 reported eczema, 20 rhinitis and 4 urticaria. Eczema was located on the hands and/or lower arms in 18 workers, on the face in 10 workers and on legs/trunk in 12 workers. After intervention in the office, 22 workers with eczema reported significant improvement, all cases of hand eczema cleared and 16 workers with rhinitis also improved. Positive patch tests to carpet extracts were found significantly more frequent in the worker cohort than in a control group comprising 47 dermatitis patients (p<0.001). Only few workers reacted with a positive response to skin prick test or in the HR test, no obvious pattern in reactions was found, and no conclusions can be made from these reactions.ConclusionThe results indicate that the reported symptoms are related to exposures from the building after renovation in 2009. A specific triggering exposure could not be identified, although chemicals from the glued carpets are suspected. The study is an example of a work place investigation, and illustrates the diversity of symptoms and exposures involved in “Sick Building” cases.

Wet work and hand eczema in apprentice nurses; part I of a prospective cohort study

Environmental exposure and personal susceptibility both contribute to the development of hand eczema. Here, we report an investigation on wet work exposure and its influence on the risk of developing hand eczema in apprentice nurses. A prospective cohort study was performed among 721 Dutch apprentice nurses. Participants recorded wet work exposure and symptoms of hand eczema using specially designed diary cards. For 533 apprentice nurses, a follow-up time of 1-3 years was completed. Diary cards were supplied by 383 students. The 1-year period prevalence of hand eczema was 23% in the first year, 25% in the second year and 31% in the third year of follow-up. Eighty-one new cases of hand eczema developed, most of which occurred during the first year of follow-up. In approximately one-third of the participants, wet work exposure exceeded the national guidelines. Frequent hand washing during traineeships [odds ratio (OR) 1.5; 90% confidence interval (CI) 1.0-2.3], frequent hand washing at home (OR 2.3; 90% CI 1.5-3.7) and having a side job involving wet work (OR 1.6; 90% CI 1.0-2.4) were independent risk factors for hand eczema. As a considerable number of apprentice nurses had already developed hand eczema during traineeships, more attention should be paid to skin protection in vocational education.

Comparison of therapeutic effect of topical Nigella with Betamethasone and Eucerin in hand eczema

Nigella sativa has been used in traditional medicine. Although it was investigated in different studies, its effect on hand eczema has not been studied yet. To compare the effects of Nigella, Betamethasone and Eucerin on severity of hand eczema and patients' life quality. In this randomized, controlled, double-blinded clinical trial, we allocated new cases of hand eczema with 18-60 years of age in three therapeutic groups (Nigella, Betamethasone and Eucerin) by using permuted blocks for randomization. Patients applied medications twice a day and followed in a 4-week period. The primary outcome of the study was changes in severity and life quality, which were assessed at the beginning, 14th and 28th days of the study by Hand Eczema Severity index (HECSI) and Dermatology Life Quality Index (DLQI) respectively. Sixty patients recruited in the study with 20 patients allocated in each study arm. Eighteen, 19 and 15 patients in Eucerin, Nigella and Betamethasone groups, respectively, attended at least one of the therapy sessions. Nigella and Betamethasone showed significantly more rapid improvement in hand eczema compared with Eucerin (P = 0.003 and P = 0.012 respectively); Nigella and Betamethasone ointments caused significant decreases in DLQI scores compared with Eucerin (P < 0.0001 and P = 0.007 respectively). No significant difference was detected in mean DLQI and HECSI of the Nigella and Betamethasone groups over time (P = 0.38 and P = 0.99 respectively). It seems that Nigella might have the same efficacy as Betamethasone in improvement of life quality and decreasing severity of hand eczema.

How to quantify skin impairment in primary and secondary prevention? HEROS: a proposal of a hand eczema score for occupational screenings

Skin scoring systems have to meet specific demands depending on their particular settings and indications, e.g. occupational screenings vs. clinical examinations, evaluating progress of treatment or supervision of preventive strategies. Until now, most scoring systems have been developed for severe cases of hand eczema. A validated quantitative scoring system for early hand eczema is still missing. The present cross-sectional study was aimed at assessing the practical value of a quantitative hand eczema score for occupational screenings (HEROS) at the workplace and its potential for identifying individuals at increased risk of work-related skin disease. Both hands of 800 male metal workers were examined for characteristic morphological patterns of hand dermatitis and quantified with HEROS. The score was validated by testing inter- and intraobserver reliability in random samples. Results of validation were compared with three already validated skin scores for distinct hand eczema (Osnabrück hand eczema severity index, hand eczema severity index, Manuscore). The score values ranged from 0 to 82 (theoretical maximum 2260), reflecting the skin condition of healthy, fit-for-work subjects. Inter- and intraobserver reliability was good to excellent. Results for reliability of the HEROS were in line with all three validated scores for hand eczema. The predictive value for identifying persons at increased risk for developing hand eczema was low. The HEROS seems to be an adequate tool for observer near-independent assessment of early hand eczema, especially for quantifying minimal skin impairment. Therefore, we propose the implementation of this scoring system for quantifying early hand dermatitis in occupational screenings.

Determinants of current hand eczema: results from case–control studies nested in the PACO follow‐up study (PACO II)

Hand eczema is often a result of the interplay of exogenous and endogenous risk factors. Epidemiological studies demonstrating the interrelationship between these factors are lacking. To analyse risk factors associated with current hand eczema and current irritant hand eczema in two case-control studies nested in a long-term follow-up study in the car industry. Eligible participants were individuals who had been followed until the end of their apprenticeship in the original cohort study (1990-1998, N = 1909). Participants were interviewed and underwent dermatological examination. Two case-control studies were nested within the cohort, one using current hand eczema cases (n = 110) and one using current irritant hand eczema cases (n = 57). Multivariable modelling was performed. The only significant finding was a positive association of atopic skin diathesis with hand eczema in both studies. Wet work >or=2 hr/day was positively related to current irritant hand eczema. Age and having an office job were inversely related to hand eczema. Atopic skin diathesis was the most important determinant of hand eczema. Constitution seems to play a dominant role compared with environmental and occupational hazards in a setting where skin protection measures are well established.

Incidence of hand eczema in female Swedish hairdressers

Objective: To estimate the occurrence of hand eczema in hairdressers in Sweden. Methods: The occurrence of hand eczema was estimated in a Swedish longitudinal retrospective cohort study including all female...

A prospective study of the development of hand eczema in an automobile manufacturing industry

We have not been able to find any prospective study of the risk of developing occupational dermatitis in the car manufacturing industry. To try to define individual predictive risk factors for the development of hand eczema and to determine the prevalence of hand eczema within 1 year in an automobile manufacturing industry, we investigated prospectively 1564 new employees during one year of employment. Only persons with previous atopic dermatitis or hand eczema were restricted to dry and clean workplaces. The employees were personally interviewed and examined before their employment. Written questionnaires were used at 3 and 12 months to obtain information on type of work, exposure, protection and hand dermatitis. All patients developing hand eczema were examined, patch tested and followed to determine the course and consequence of their eczema. The risk turned out to be only 4% on average, but significantly higher in females (6%). Certain sections within the factory such as wet work (canteen/kitchen and cleaning) and work in the paint shop with high exposure to organic solvents carried significantly higher risks. Heavy exposure to mineral oil, a known risk factor, was effectively counteracted by the extensive use of protective gloves to yield a lower than average prevalence in the press and body shop. Individual risk factors for the development of hand eczema were previous hand eczema, atopic dermatitis, but also wool intolerance and hay fever as isolated phenomena. Most cases of hand eczema were mild, of irritant contact type and only 1 employee developed an allergic contact dermatitis due to the working environment.(ABSTRACT TRUNCATED AT 250 WORDS)

Allergic Contact Dermatitis in Hand Eczema

Two hundred and twenty cases of hand eczema were evaluated for uncomplicated allergic contact dermatitis. In 12% of the 220 patients, the diagnosis was established with the aid of a standard screening tray. Another 5% of the cases were diagnosed as a result of testing with additional allergens. The hand eczema in these patients (17%) changed dramatically as a result of allergic contact investigation.

Tickle responses in eczema patients and normal controls.

Kepecs’ Tickle Test was applied in a modified form to 69 eczema patients and 20 normal controls. Whilst Kepecs’ ideas were supported, the presence or duration of an After-Sensation was found to distinguish between eczema patients with and without overt emotional disturbance more than the response during application of a 2-min tickle stimulus; but tickle responses on the eczema itself, rather than unaffected forehead and palm, did powerfully discriminate. Hand eczema cases suggest the possibility that the cathexis or counter-cathexis of the hands, as executants of conflictful sexual or aggressive impulses, explains the different ‘gradients’ of ticklishness in the two types of eczema patient. The responses seem to interact meaningfully with several personality variables. Further work is needed.