Chronic hand eczema: Common questions and practical recommendations from the EADV Contact Dermatitis Task Force

Area of Science:

• Dermatology
• Immunology
• Public Health

Background:

• Chronic hand eczema (CHE) is a widespread skin condition affecting quality of life and daily functioning.
• It stems from irritant contact dermatitis, allergic contact dermatitis, atopic dermatitis, or unclassified causes, often linked to occupational exposures.
• Epidemiological data is likely underreported, with higher incidence in women but greater severity in men.

Purpose of the Study:

• To provide a comprehensive overview of chronic hand eczema (CHE) through a question-and-answer format.
• To cover etiopathogenesis, epidemiology, clinical presentation, diagnosis, prognosis, QoL impact, and management strategies.
• To identify current treatment gaps and future research directions for CHE.

Main Methods:

• This is a review article structured in a question-and-answer format.
• It synthesizes existing knowledge on the etiopathogenesis, clinical aspects, and management of CHE.
• The review discusses various subtypes, diagnostic approaches, and therapeutic interventions.

Main Results:

• CHE results from diverse causes, including occupational exposures, and involves complex immune responses and skin barrier dysfunction.
• The condition has significant psycho-social and economic consequences, comparable to other chronic diseases.
• Current treatments include topical and systemic therapies, with emerging biologics like JAK inhibitors showing potential for severe cases.

Conclusions:

• Effective management of CHE requires understanding its varied subtypes and triggers.
• Preventive measures and proper hand care are crucial.
• Further research into CHE pathogenesis is essential for developing targeted, long-term therapies beyond symptom management.