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Patch Testing in Chronic Hand Eczema: A Multicentre Study in Portugal
André Aparício Martins1, Patrícia Almeida2, Inês Lobo3
1Dermatology Department, Hospitais da Universidade de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal.
Background:
Chronic hand eczema (CHE) is a common dermatitis with morphological and aetiological heterogeneity. Allergic contact dermatitis (ACD) is a major aetiology, and patch testing (PT) is essential to characterize CHE and guide its treatment and prevention.
Objectives:
Determine the prevalence of ACD in CHE patients, describe relevant allergens, and identify differences in atopic and occupational settings.
Methods:
We conducted a multicentric retrospective observational study, based on PT results of CHE patients evaluated between 2021 and 2023, in Portuguese dermatology departments, comparing atopic dermatitis and non-atopic and occupational and non-occupational groups.
Results:
Among 1267 patients (391 males/876 females) with CHE, representing 43% of all patients tested, 57% had at least one positive PT reaction, 41% of which were currently relevant. The most common allergens included metals, preservatives, fragrances, rubber constituents and 2-hydroxyethyl methacrylate. The occupational group revealed higher relevance rates for metals and benzisothiazolinone, whereas in the atopic dermatitis group, methylisothiazolinone and Myroxylon pereirae were considered more frequently relevant.
Conclusions:
CHE patients present a high sensitization rate and ACD is a main aetiology. Methylisothiazolinone and 2-hydroxyethyl methacrylate are confirmed as emergent allergens. The higher relevance rate of metals and benzisothiazolinone in the occupational group reinforces the importance of PT in the occupational setting.
