Etiology of hand dermatitis among patients referred for patch testing.
BACKGROUND
Hand dermatitis affects many people and has numerous causes. Few reports have looked at the etiology of hand dermatitis across broad demographics.


OBJECTIVE
The purposes of this investigation were to (1) determine the causes of hand dermatitis in the population patch-tested at a dermatologic referral clinic, (2) report occupations frequently associated with hand dermatitis, and (3) indicate which substances were the more common allergens among individuals evaluated by patch testing for hand dermatitis.


METHODS
A retrospective analysis of patch-test data on 1,034 patients who were evaluated during an 8-year period was performed.


RESULTS
Hand dermatitis affected 32% of all patients who underwent patch testing. Allergic contact dermatitis was diagnosed most often (54.4%), followed by irritant contact dermatitis (27.4%). Among women, irritant contact dermatitis of the hands peaked in the third decade and then diminished whereas allergic contact dermatitis of the hands remained fairly constant among patients between 21 and 60 years of age. In contrast, irritant contact dermatitis and allergic contact dermatitis in men peaked in the fifth decade of life. In both genders, hand dermatitis was rare among those 20 years of age or younger and among those 61 years of age or older. Fifty-six percent of hand dermatitis was related to occupation. Health care workers were most often affected by occupational hand dermatitis. The most common allergens for both occupational and non-occupational hand dermatitis were quaternium-15, formaldehyde, thiuram mix, and carba mix.


CONCLUSIONS
Since more than half of hand dermatitis cases may be related to occupation, a thorough history should be taken by a knowledgeable clinician. Potentially relevant allergens in the workplace must be identified and tested. These allergens may not be contained in standard trays.
Templet
Julie T
JT
University of Kansas Medical Center, Kansas City, KS, USA.
Hall
Sandra
S
Belsito
Donald V
DV
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000485:Allergens / Q000009:adverse effects* / Q000145:classification; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006229:Hand Dermatoses / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007615:Kansas / Q000453:epidemiology; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010328:Patch Tests / Q000706:statistics & numerical data; D012189:Retrospective Studies
D000485:Allergens