Tobacco smoking and hand eczema – is there an association?

Abstract

SummaryBackground. Numerous risk factors have been suggested for hand eczema. This systematic review evaluates the association between tobacco smoking and hand eczema. Objective. To review the literature systematically on the association between smoking and hand eczema. Methods. The PubMed and EMBASE databases were searched up to 27 January 2015 for articles on the association between tobacco smoking and hand eczema, including human studies in English and German only. Experimental studies, studies on tobacco allergy, case reports, reviews and studies on second-hand smoking were excluded. Results. Twenty articles were included. Among studies in occupational settings, three of seven found a statistically significant positive association between tobacco smoking and hand eczema prevalence rate, as did four of eight population-based studies. The association was stronger for studies in occupational settings than for population-based studies. No studies reported tobacco to be a clear protective factor for hand eczema. Two of five studies regarding severity found a positive association between smoking and hand eczema severity. Conclusion. Overall, the data indicate that smoking may cause an increased frequency of hand eczema, particularly in high-risk occupations. However, data from studies controlling for other risk factors are conflicting, and few prospective studies are available. Studies controlling for other risk factors are needed, and information regarding the diagnosis of subclasses of hand eczema, as well as severity, may be important.

Hand eczema: epidemiology, prognosis and prevention

“…62 Several factors influencing the prognosis of occupational HE have previously been identified. 63 Recent studies have pointed to lifestyle factors as risk factors for prolonged disease, in particular tobacco smoking, 62,65,66 but also stress and lack of physical exercise seems to have a negative influence on the prognosis. 61,62 This change in risk factors over time may partially be due to the positive effects of information and education given to this specific group of patients.…”

“…84 Skincare programmes have been developed focusing on simple advice on handwashing and use of disinfectants, emollients and gloves. 62,65,66 Notification to the authorities should be carried out in accordance with National regulations when the HE is suspected to be work-related. 77,80,84,86 A guided talk based on the basic recommendations, given by a nurse and lasting for a maximum of 20 min, is recommended.…”

Associations between lifestyle factors and hand eczema severity: are tobacco smoking, obesity and stress significantly linked to eczema severity?

“…Two Danish population studies found that tobacco smoking was associated with hand eczema prevalence and nickel sensitization, respectively . In a recent review, it was concluded that an increased prevalence of hand eczema in smokers was, in particular, related to occupational hand eczema . However, another systematic review including a meta‐analysis did not confirm tobacco smoking to be a risk factor for hand eczema .…”

Handekzeme – Differenzialdiagnosen, Diagnostik und Therapien

“…In einer anderen aktuellen Übersicht über 20 publizierte Arbeiten zum Zusammenhang von Tabakrauchen und Handekzem wiesen drei von sieben Arbeiten mit berufsbezogenem Hintergrund und vier von acht bevölkerungsbezogenen Arbeiten eine signifikante positive Assoziation zwischen Tabakrauchen und der Prävalenz des Handekzems nach. Zwei von fünf Studien zur Erkrankungsschwere zeigten eine positive Assoziation zwischen Rauchen und Schwere der Handekzeme . Keine der Studien zeigte einen protektiven Effekt von Rauchen für Handekzeme .…”

“…Zwei von fünf Studien zur Erkrankungsschwere zeigten eine positive Assoziation zwischen Rauchen und Schwere der Handekzeme . Keine der Studien zeigte einen protektiven Effekt von Rauchen für Handekzeme . Der Einfluss von Tabakkonsum auf die Entstehung und Erhaltung des Handekzems kann basierend auf der derzeitigen Datenlage zum gegebenen Zeitpunkt nicht abschließend bewertet werden.…”