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Updated: Jul 14, 2026

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Hand Eczema Referred for Patch Testing: Retrospective Study in Shanghai, China From 2018 to 2023.

Chengbin Ye1, Xiandong Gu1, Chengwen Fei1

  • 1Allergic Dermatoses Clinical Center, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, China.

The Journal of Dermatology
|July 13, 2026
PubMed
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This study identified key allergens in Chinese patients with hand eczema (HE), finding N-Isopropyl-N-Phenyl-4-Phenylenediamine and rubber allergens were more common in HE cases. Factors like sex, age, and occupation influence allergen sensitivity.

Area of Science:

  • Dermatology
  • Allergology
  • Epidemiology

Background:

  • Hand eczema (HE) presents a substantial socioeconomic challenge, particularly in severe and occupational forms.
  • Identifying specific allergens and risk factors is crucial for managing HE in Chinese populations.

Purpose of the Study:

  • To determine the primary allergens and associated factors in Chinese patients with HE undergoing patch testing.
  • To analyze differences in allergen prevalence between HE and non-HE groups.

Main Methods:

  • Retrospective cohort study of 788 HE cases from 4438 patients patch-tested in Shanghai (2018-2023).
  • Statistical analysis including false discovery rate (FDR) correction and multivariable adjustments to identify significant allergens and risk factors.
  • Analysis of demographic (sex, age) and occupational factors, and history of atopic dermatitis.
Keywords:
contact dermatitishand eczemaoccupational skin diseasepatch test

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Main Results:

  • The HE group exhibited an 82.23% patch-test positivity rate.
  • N-Isopropyl-N-Phenyl-4-Phenylenediamine and other rubber allergens were significantly more prevalent in the HE group (FDR-adjusted p < 0.05).
  • Top allergens included nickel sulfate, dodecyl gallate, methylisothiazolinone, cobalt chloride, and methylisothiazolinone/methylchloroisothiazolinone. Polysensitization was higher in females, while occupational allergen sensitivity was higher in males. Fragrance allergies were more common in those over 40. Hairdressers and beauticians showed increased sensitivity to preservatives and p-phenylenediamine.

Conclusions:

  • Significant differences exist in patch test reactions between HE and non-HE individuals.
  • Allergens, sex, age, atopic dermatitis history, and occupation are critical factors in HE.
  • Further research with balanced samples is needed to validate occupational allergen associations.