Hand eczema: causes, course, and prognosis I.

BACKGROUND: Hand eczema is a common dermatosis. The course is often protracted. The prognosis is not well described. OBJECTIVE: To describe in detail a consecutive cohort of hand eczema patients with regard to aetiology and morphology as well as the dynamics of the hand eczema. PATIENTS AND METHODS: This prospective study included 522 consecutive patients (175 men and 347 women with hand eczema) seen in 1 year in a private practice of dermatology. 425 (81%) of the patients were patch tested in relation to the current study. Most of the remainder had been previously patch tested. RESULTS: 38% had mild dermatitis, 49% had dermatitis of moderate severity, and 11% had severe dermatitis. 23% had had dermatitis for more than 10 years. 33% had irritant contact dermatitis, 13% of the men and 20% of the women had allergic contact dermatitis, and 15% of the men and 16% of the women had atopic dermatitis. For 34% of the men and 29% of the women, the dermatitis was certainly or possibly occupational. There was no relationship to smoking. CONCLUSIONS: The majority of this cohort of hand eczema patients had long-standing disease. Irritant contact dermatitis was the most common aetiological diagnosis.