Predictive Model for Allergic Contact Dermatitis in Patients With Hand Eczema

Patch tests are only indicated for hand eczema when it is diagnosed as chronic. A positive reaction of current relevance requires a change in treatment strategy. Knowing which clinical factors are associated with current relevance would allow tests to be performed sooner.

To develop a model for predicting currently relevant patch test positivity in patients with hand eczema only.

Retrospective study of patients with hand eczema only. We collected data on age, sex, time since onset, occupation, and history of atopic dermatitis. We built a predictive logistic regression model and assessed discrimination by computing the area under the receiver operating characteristic curve.

We included 262 patients; 66.03% had positive patch tests (28.6% of current relevance). Univariate analysis detected significant associations between positivity of current relevance and employment as a hairdresser-aesthetician, a personal history of atopy, male sex, and a time since onset of over 6 months. Multivariate analysis confirmed employment as a hairdresser-aesthetician as an independent risk factor and male sex and a personal history of atopy as protective factors. The score suggested by the predictive model was 2.316(hairdresser-aesthetician)-1.792(atopic dermatitis)-0.601(male sex).

Occupation, sex, and a history of atopy influence the likelihood of patch test positivity of current relevance in patients with hand eczema in Spain. Our model suggests that a diagnosis of chronic eczema is not necessarily an indication for patch testing. Future studies with larger samples are needed to determine the true usefulness of predictive models in this setting.