Hand eczema (hand dermatitis)

1911

Refers to an inflammation of the skin of the hands.

Associated with clinical signs of redness, scaling, skin infiltration, edema, vesicles, areas of hyperkeratosis, erosions, and fissures.

Characterized by pruritus, soreness, erythema, edema, weeping, and vesiculation in the acute stage, and pruritis, scaling, hyperkeratosis, and fissuring of the skin, in the chronic stage.

Described as chronic if the process lasts for more than three months or relapses twice or more per year.

Can be aggravated by occupational or routine household activities.

Prevalence of 4% among adults in the general population.

Lifetime prevalence approx 15%.

One year prevalence of up to 10%, depending upon the disease definition.

Incidence of work related cases is between 0.7 and 1.5 cases per 1000 workers per year.

More common in females.

Higher incidence among occupations such as hairdressing.

Significant variation in the severity and the appearance over time with cracks and blisters that may prevent work.

Most common cause is related to contact with mild toxic irritants such as water and soaps, causing irritant contact dermatitis.

Allergic contact dermatitis is less common than irritant contact dermatitis and is is related to a specific contact allergy to rubber, nickel, or perfumes.

Atopic dermatitis is an endogenous cause of hand eczema.

One third to one half of patients with hand eczema may have atopy.

Atopy may manifest as dermatitis of the hands.

Hand eczema may have more than one cause, and several types have no known cause.

Hyperkeratotic eczema, nummular eczema, vesicular hand eczema and pulpitis have no known cause.

Risk factors include occupations requiring frequent handwashing, and the use of occlusive gloves.

Hand eczema may be confused with psoriasis and mycosis.

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