Hair cosmetic products contain various chemicals which are partly potent contact sensitizers. These may cause occupational hand eczema in hairdressers, but also scalp and face dermatitis in consumers. To (i) highlight differences between the spectrum of occupational and non-occupational exposure reflected in sensitization, and (ii) correlate trends in the last decades with regulatory interventions (or the lack thereof). Patch test and clinical data collected by the IVDK (https://www.ivdk.org) between 01/1995 and 12/2020 were subjected to a pooled re-analysis. Age-stratified sensitization prevalences in female hairdressers and consumers, respectively, were calculated for 2-yearly intervals spanning the study period. Log-binomial regression models were employed to estimate the association between contact allergy and (i) subgroup (hairdresser vs. consumer), (ii) a 3-level age category, and/or (iii) time period, respectively. Hair dyes were the most frequent sensitizers in hairdressers and consumers; however, there was a marked increase in (particularly the young) consumers. Pyrogallol had been banned in 1992 but still elicited positive patch test reactions even in the young. Hydroquinone, banned in 2013 in dyes, showed no decline in sensitization prevalence. Glyceryl thioglycolate has been withdrawn and later banned in Germany since around 1995, which caused contact allergy prevalence to drop to almost zero in the youngest age group, largely until today. As a limitation, putatively differing selection for patch testing render prevalences difficult to compare between hairdressers and consumers. The importance of hair dye allergy is evident, needing continued efforts to increase product safety from the manufacturing and regulatory side. The potential of (self-)regulatory intervention is well illustrated by the decline of contact allergy to glyceryl thioglycolate.

108 Chronic hand eczema is a type 2 disease: evidences from integrated clinical trial and molecular profiling

028 Transcriptomic profiling of hyperkeratotic hand eczema skin with comparison to atopic dermatitis and psoriasis

Evidence for moderate to severe chronic hand eczema (CHE) treatments in clinical practice is limited. The objective was to investigate treatment patterns in patients with moderate to severe CHE, and in those with an inadequate response to topical corticosteroids (TCS) or in whom TCS were contraindicated. This was a multinational retrospective physician chart review. Physicians who routinely diagnosed and treated CHE were recruited in Canada, France, Germany, Italy, Spain, and the UK and provided data on adult patients with moderate to severe CHE treated with TCS over the past 12months or for whom TCS were contraindicated. A total of 292 physicians provided data on 1939 patients. Worst severity of CHE in the 12-month study period was judged by the physician to be moderate in 56.8% and severe in 43.2% of patients. Overall, 6.7% of patients received topical calcineurin inhibitors, 3.9% phototherapy, 6.8% alitretinoin, 11.1% traditional orals (acitretin, azathioprine, oral corticosteroids, cyclosporine, methotrexate), 8.0% biologics, and 1.7% oral Janus kinase (JAK) inhibitors. An inadequate response or contraindication to TCS was reported in 39.9% of patients (27.4% progressed to phototherapy/systemics; 12.1% with adverse events or an inadequate response to high/ultra-high potency TCS, and 0.4% contraindicated). Among these patients, the highest line of treatment during the 12-month period was biologics in 29.2%, alitretinoin in 22.3%, oral JAK inhibitors in 5.1%, traditional orals in 33.3%, and phototherapy in 9.6% of patients. There were no significant differences in phototherapy/systemic treatments between patients with moderate and severe disease in this subgroup. Despite being a first-line treatment, 40% of patients with CHE were inadequately treated with or contraindicated to TCS. Over one-quarter of patients progressed to phototherapy or systemic therapy. These results suggest a lack of effective and well-tolerated topical treatment options in CHE. Graphical Abstract available for this article.

PCR214 Sex Differences in Chronic Hand Eczema (CHE) Triggering Factors: Comorbidities, Lifestyle, and Exposures Findings From a Multinational Study in Six Countries

BackgroundWork-related hand eczema (WRHE) is a common occupational disease in Europe, associated with impaired quality of life and a substantial socioeconomic burden. As skin protection behaviour critically influences disease course, mobile health interventions may help establish and maintain routines. The smartphone app ‘Mein Hautschutz im Alltag’ (MiA; German for ‘My Skin Protection in Everyday Life’) was developed to support patients with WRHE, but its clinical effectiveness has not yet been evaluated.MethodsThis quasi-randomised controlled trial will enrol 286 adults with WRHE attending a 3-week inpatient programme at a specialised dermatology clinic. Participants are allocated in clusters based on admission date to either care as usual (control) or care as usual plus an individual goal-setting interview and a 6-month access to the MiA app (intervention). The primary outcome is change in skin protection behaviour from baseline to 6 months post-discharge. Secondary outcomes include clinical and self-rated skin condition, action control, and quality of life. Analyses will follow the intention-to-treat principle using linear mixed models.DiscussionThis is the first systematic evaluation of the MiA app’s effectiveness in patients with WRHE in a quasi-randomised controlled trial. By combining a structured goal-setting interview with the MiA app, the intervention aims to support the long-term adoption and maintenance of protective behaviours in both occupational and private settings. Key limitations include the quasi-random allocation by admission date (no true randomisation), lack of allocation concealment and blinding, reliance on self-reported primary outcomes, and a 6-month follow-up. Despite these constraints, the pragmatic design aims to generate decision-relevant, real-world evidence for WRHE care.Trial registrationGerman Clinical Trial Registry DRKS00036627. Registered on April 14, 2025.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13063-025-09295-7.

IntroductionThe prevalent condition known as hand eczema has been associated with substantial decreased quality of life, as well as considerable social and occupational expenses. Even though hairdressing is a significant source of wealth, it is linked to several kinds of medical problems mainly skin conditions. Limited studies conducted in Ethiopia to assess self-reported prevalence of hand eczema and associated factors.ObjectiveThis study aims to assess self-reported prevalence of hand eczema and associated factors among hairdressers of Debre Berhan city.MethodsA cross-sectional study was conducted among 435 hairdressers of Debre Berhan city in North Eastern Ethiopia from January 10 to February 20, 2025. A simple random sampling technique was used to select hair dressers. Data was collected using a structured questionnaire adapted from Nordic occupational skin questionnaire and observational checklist through face to face interview and observation. Multivariable binary logistic regression was employed to identify associated factors of hand eczema.ResultsPrevalence of hand eczema among hairdressers of Debre Berhan city was 56.9%. Poor knowledge (AOR = 2.89, 95% CI: 1.199–4.963), not utilizing personal protective equipment consistently over the years (AOR = 3.8, 95% CI: 2.183–7.012), low hand washing frequency per day (AOR = 3.4, 95% CI: 1.399–6.433) and not taking OHS training (AOR = 4.8, 95% CI: 2.617–8.709) were identified factors of hand eczema.ConclusionsPrevalence of hand eczema among hair dressers in Debre Berhan city was high. Poor knowledge, not utilizing personal protective equipment consistently over the years, low hand washing frequency per day and not taking OHS training were identified factors. Hair dressers should utilize proper type of personal protective equipment before starting any activities in the work place. Inclusion of hand eczema education in Technical and Vocational Educational and Training (TVET) or policy-level interventions would enhance occupational health awareness, early prevention strategies and long-term skin protection practices among hairdressers.

Chronic hand eczema in U.S. adults: symptom control and quality of life impacts

Chronic hand eczema is a highly prevalent inflammatory skin disorder associated with substantial impairments in quality of life and social interactions. Topical corticosteroids and calcineurin inhibitors are conventional treatments often limited by the achievement of suboptimal disease control and concerns regarding long-term safety. Delgocitinib 2% cream, the first topical pan-Janus kinase inhibitor approved in Europe for adult patients with moderate-to-severe chronic hand eczema, represents a significant therapeutic advance. By simultaneously targeting multiple cytokine pathways implicated in chronic hand eczema pathogenesis, delgocitinib offers a corticosteroid-sparing alternative with minimal systemic absorption. Pivotal phase III clinical trials (DELTA 1, 2, and 3) demonstrated significant reductions in disease severity, itch, and pain compared with baseline, with a favorable safety profile sustained over long-term treatment. Recent investigations in adolescent and Asian populations are further expanding the therapeutic profile of topical delgocitinib across different age groups and ethnic backgrounds. Both the cream and ointment formulations have been assessed in clinical settings, with distinct utility depending on anatomical site and barrier integrity. Beyond chronic hand eczema, topical delgocitinib has shown efficacy in atopic dermatitis, and preliminary evidence is emerging in other inflammatory skin diseases, including vitiligo, lichenoid dermatoses, and hair disorders. This review provides an updated overview of the biological rationale for pan-Janus kinase inhibition, summarizes the most recent outcomes of topical delgocitinib in chronic hand eczema and atopic dermatitis management, and outlines its potential new applications in the landscape of immune-mediated skin diseases.

ABSTRACTIntroductionChronic hand eczema (CHE) is a highly prevalent dermatology‐related occupational hazard. This condition, which is a distinct diagnosis from atopic dermatitis (AD), can be quite symptomatic with implications for one's personal and professional life. Many therapeutic interventions exist for CHE, and the current study determined—through network meta‐analyses (NMAs)—the relative efficacy of the newer treatments for CHE.MethodsData for eligible studies were identified after systematically reviewing the literature in PubMed and Scopus. Eligible studies were those that had an arm investigating the impact of monotherapy on 12‐ or 16‐week changes in Hand Eczema Severity Index (HECSI) scores. We conducted sensitivity analyses where network meta‐regressions were performed to (ecologically) adjust for variation due to age and sex. Base and sensitivity analyses were adjusted for disease severity at baseline.ResultsWe identified 5 eligible studies—across which there were 10 active comparators. Among the active comparators were two treatments approved by the Food and Drug Administration (FDA) and European Medicines Agency (EMA) for the treatment of CHE, namely, alitretinoin 30 mg once daily (oral) and delgocitinib 20 mg/g twice daily (topical). We estimated pairwise relative effects using the mean difference (i.e., mean reduction) in the respective HECSI scores; furthermore, efficacy was ranked with Surface Under the Cumulative Ranking Curve (SUCRA) values.ConclusionsWe attempted to contribute to the existing CHE literature by producing comparative information on its treatments' relative efficacy; moreover, we found no published NMA study on available treatments for CHE before the conduct of our work. Our results can guide clinical decision‐making.

Hand eczema (HE) can cause itching, fissures and pain, and reduce overall functioning, including the ability to work. However, few studies have examined self-rated work ability in individuals with HE. To investigate self-reported work ability in individuals with and without HE in a middle-aged cohort in the north of Finland. As part of the 46-year follow-up visit of a large birth cohort study program, participants were invited to complete an extensive questionnaire, which included questions about their education level, health status and health-related lifestyle. The presence of clinician -diagnosed HE was also reported as part of the questionnaire, as was participants' work capability, measured with the Work Ability Score. HE was reported by 853/6643 (12.8%) participants, more commonly by females (15.6%) than males (9.5%; p < 0.001). Poor work ability was more frequent in participants with HE (23.9%) than those without (17.8%; p < 0.001). After adjusting for confounding factors (sex, education level, smoking status, physical activity, body mass index, symptoms of depression and musculoskeletal disorders) individuals with HE had a higher risk than those without of reporting poor work ability (adjusted odds ratio 1.33, 95% confidence interval, 1.09-1.62). HE is associated with poor self-assessed work ability.

A matching-adjusted indirect comparison (MAIC) was performed comparing the efficacy of delgocitinib and dupilumab in patients with atopic hand eczema (AHE), one aetiological subtype of chronic hand eczema (CHE). DELTA 1/2 were phase 3 trials in which adults with moderate to severe CHE received delgocitinib cream 20mg/g or cream vehicle twice daily for 16weeks. LIBERTY-AD-HAFT was a phase 3 trial in which patients with moderate to severe AD with hand or foot involvement received subcutaneous dupilumab or placebo every 2weeks for 16weeks. An anchored MAIC was conducted using individual patient data (IPD) from DELTA 1/2 and aggregate published data from LIBERTY-AD-HAFT, with vehicle and placebo as the common anchor. IPD from patients with AHE as the primary subtype in DELTA 1/2 were weighted to match age, race, sex and baseline Hand Eczema Severity Index (HECSI) score in LIBERTY-AD-HAFT. LIBERTY-AD-HAFT included 133 patients (dupilumab, n = 67, placebo, n = 66) while DELTA 1/2 included 345 patients with AHE; the effective sample size after weighted matching was 201 (delgocitinib, n = 128, cream vehicle, n = 73). Anchor-adjusted odds ratios comparing delgocitinib versus dupilumab at week 16 were 1.1 (95% CI: 0.3, 3.4; p = 0.890) for Investigator's Global Assessment for Chronic Hand Eczema / Hand and Foot Investigator's Global Assessment score 0/1, 1.2 (95% CI: 0.4, 3.2; p = 0.773) for HECSI 75 and 1.3 (95% CI: 0.4, 4.9; p = 0.661) for HECSI 90 while response difference for HECSI percent improvement was 11.7% (95% CI: -9.2%, 32.7%; p = 0.273). Topical delgocitinib and dupilumab in patients with AHE had comparable efficacy, with all results being numerically in favour of delgocitinib, although not statistically significant. NCT04871711, NCT04872101, NCT04417894.

Prevalence of Self-Reported Physician Diagnosis of Chronic Hand Eczema in Adults: A Cross-Sectional Study of More Than 10,000 Participants in the General Population – Results From the CHECK Study in the United States

The Impact of Chronic Hand Eczema on Occupation, Work Productivity, and Activity Impairment – Results From the CHECK Study in the United States

Budget Impact Analysis of Delgocitinib Cream for Moderate to Severe Chronic Hand Eczema in the United States

Hand Eczema Workers’ Compensation Claims: Real-World Data Analysis in the United States

Self-Reported Disease Severity, Symptoms, and Treatment of Chronic Hand Eczema – Results From the CHECK Study in the United States

Demographics, Clinical, and Treatment Characteristics of Patients With Moderate to Severe Chronic Hand Eczema in the United States – A Retrospective Claims Analysis

Demographics and Clinical Characteristics of Chronic Hand Eczema patients – Results from the CHECK study in the United States

Healthcare Resource Utilization and Financial Burden Among Patients With Chronic Hand Eczema – Results From the CHECK Study in the United States