Clinical manifestations of hand eczema compared by etiologic classification and irritation reactivity to SLS.
Hand eczema is a common skin disease. Because of its variable etiologies and clinical manifestations, it is difficult to determine the etiology from the clinical manifestation. Among the contact allergens, nickel is the most common. Patients with hand eczema and a nickel allergy have a poorer prognosis than patients without a nickel allergy. The reason is still uncertain; suggestions include persistent exposure to nickel or a weak skin barrier. The purpose of our study was to identify the characteristic clinical manifestations by etiology and to compare the skin barrier state between patients with nickel allergies and those without them. Ninety-three patients were classified into 4 types; irritation contact type, allergic contact type, atopic type and mixed type. After the sodium lauryl sulfate (SLS) test to compare the skin barrier state, visual score and transepidermal water loss (TEWL) were measured and analyzed statistically. From this study, it was not possible to ascertain a statistical difference, however a few characteristic clinical manifestations according to etiology can be stated. There was no difference in the visual scoring system or the TEWL after the SLS irritation test between the nickel-allergy group and the non-allergy group. Therefore, we believe that the poor prognosis of hand eczema with nickel allergy may be due to the nickel allergy itself rather than skin barrier state.
Kang
Yun Chul
YC
Department of Dermatology, Yonsei University Wonju College of Medicine, Korea.
Lee
Sanghoon
S
Ahn
Sung Ku
SK
Choi
Eung Ho
EH
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D017449:Dermatitis, Allergic Contact / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000473:pathology; D017453:Dermatitis, Irritant / Q000175:diagnosis / Q000473:pathology; D004485:Eczema / Q000145:classification* / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006229:Hand Dermatoses / Q000145:classification* / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007223:Infant; D007509:Irritants; D008297:Male; D008875:Middle Aged; D009532:Nickel / Q000009:adverse effects; D010328:Patch Tests; D012967:Sodium Dodecyl Sulfate; D014870:Water Loss, Insensible
D007509:Irritants; D012967:Sodium Dodecyl Sulfate; D009532:Nickel