Atopic profiles, familial histories, and coexisting conditions associated with hand eczema

Many of the eczema cases seen by dermatologists involve the hands. The discomfort and embarrassment of hand dermatitis in any of its forms may compromise a patient's quality of life, causing frustrated attempts to identify the cause of the disease and engendering disappointment with treatment failures.

The authors assessed the severity scores for each patient, personal and familial histories of atopy, coexisting conditions, triggers of irritation, types of treatments, and their success rates. The authors administered a comprehensive survey to 50 consecutive patients presenting with eczematous dermatitis on the ventral aspect of the hands. The authors used a novel hand eczema severity index and a questionnaire that assessed personal and familial histories of atopy as well as coexisting conditions, triggers, and sources of irritation; types of treatments employed; and success rates. Patients were also encouraged to complete a composite quality of life assessment.

Results reveal a high frequency of personal and familial atopy, a 58% prevalence of contact allergy, a 67.4% history of hay fever, 25.6% cases of asthma, and a 44% incidence of fungal infection, which was one of the most common coexisting conditions.

Both topical immunomodulators and topical corticosteroid therapy treatments demonstrated an impressive efficacy. An overlap should be considered when clinical symptoms and histological results vacillate between psoriasis and eczema.