Hand eczema: epidemiology, prognosis and prevention

Abstract

Hand eczema (HE) is a heterogeneous and often chronic disease located to the hands and wrist, and frequently associated with eczema on the feet. The aetiology is diverse, and the eczema may present with a variety of clinical symptoms. Acute and chronic stages appear; severity varies from mild to moderate and severe, and flares may be frequently recurrent or rare. The divergent aetiology and varied morphology of HE is sometimes tricky and may be challenging to the dermatologist. This review has focus on epidemiology, prognosis and prevention of HE, and intends to point towards some practical advice on how to diagnose, inform and guide HE patients.

Hand eczema—A growing dermatological concern during the COVID ‐19 pandemic and possible treatments

“…Apart from the possibility of inducing irritant contact dermatitis, the increased exposure to the provoking factors of HE during the COVID-19 pandemic may cause the development of allergic contact dermatitis and sensitization to allergens in atopic individuals as an effect of the facilitated migration of allergens through the skin which is secondary to the destruction of the epidermal surface lipids and disruption of the epithelial barrier. 4 In view of the above, we believe that primary prevention of HE should be intensively promoted during the COVID-19 pandemic. Evidence-based interventions include using moisturizers in combination with barrier creams and constant education on skin protection.…”

“…and/or exacerbation. 3,4 The necessity to use these measures during the COVID-19 pandemic may increase the frequency of HE.…”

“…Evidence-based interventions include using moisturizers in combination with barrier creams and constant education on skin protection. 4 In case of active HE, a detailed history must always be taken, and additional examination such as patch skin testing or atopy score should be considered to identify underlying contact allergy or atopic dermatitis. 6 The treatment of HE varies based on the severity of symptoms and disease phase (acute, chronic), with emollients and moisturizers being the baseline.…”

Hand eczema: treatment

“…The aetiology is manifold from endogenous disease (atopy) to exogenous factors (irritant and/or allergic contact dermatitis) that frequently overlap. 2,3 Clinical manifestations may be diverse, from vesiculous and erosive to hyperkeratotic and desquamative. Its time course may be acute, recurring or chronic and long-lasting.…”

Handekzem – wieder von Interesse

“…Das irritative Handekzem sehen wir daher durchaus häufiger in den Sprechstunden. Das chronische Handekzem (CHE) galt als vernachlässigte Erkrankung [1]. Erfreulicherweise lesen wir nun wieder vermehrt zum CHE in unseren dermatologischen Zeitschriften und das ist gut so und wichtig.…”