Atopy, nickel sensitivity, occupation, and clinical patterns in different types of hand dermatitis.
BACKGROUND
The etiologic diagnosis of hand dermatitis (HD) is often difficult. Knowledge of the relationship between atopy and nickel sensitivity as risk factors for HD is limited.


OBJECTIVE
To compare irritant contact dermatitis, allergic contact dermatitis, and dyshidrotic eczema relative to personal atopy, patch-testing results, occupation, and clinical patterns.


METHODS
From patients referred for patch testing, 714 consecutive individuals with HD were retrospectively studied.


RESULTS
Half of the patients had eczema confined to the palms. The dorsal pattern was more prevalent in atopic patients, compared to nonatopic patients. Irritant contact dermatitis was the most frequent diagnosis (55.3%), followed by allergic contact dermatitis (24.4%) and dyshidrotic eczema (20.3%). Among housewives, health workers, and mechanics, irritants were of much greater importance than allergens whereas among hairdressers and bricklayers, the opposite was found. The prevalence of personal atopy did not differ significantly between different types of HD. Nickel sensitivity was much less frequent in irritant contact dermatitis than in allergic contact dermatitis or dyshidrotic eczema. The distribution of clinical patterns was similar.


CONCLUSIONS
This study suggests that different etiologic diagnoses of HD cannot be distinguished by clinical pattern, prevalence of personal atopy, or nickel-sensitivity.
Magina
Sofia
S
Department of Dermatology, Hospital de S. João, Porto, Portugal. smagina@med.up.pt
Barros
Maria Antónia
MA
Ferreira
José Alberto
JA
Mesquita-Guimarães
José
J
D000328:Adult; D017449:Dermatitis, Allergic Contact / Q000453:epidemiology* / Q000209:etiology; D003876:Dermatitis, Atopic / Q000453:epidemiology / Q000209:etiology; D009783:Dermatitis, Occupational / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006229:Hand Dermatoses / Q000139:chemically induced / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009532:Nickel / Q000009:adverse effects*; D010328:Patch Tests; D011174:Portugal / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies
D009532:Nickel