title: Prevalence and morphology of hand eczema in patients with atopic dermatitis.
abstract: BACKGROUND
  Patients with hand eczema frequently have a history of atopic dermatitis or atopy. No specific morphologic pattern of hand eczema helps distinguish atopic hand eczema from other etiologies. There are few studies of hand eczema prevalence and morphology in a well-defined population of patients with atopic dermatitis.
  
  
  METHODS
  We evaluated 777 consecutive patients with atopic dermatitis (diagnosed by standard criteria) for hand involvement. An additional 100 patients had further evaluations, including evaluation of the historical and morphologic characteristics of their hand eczema.
  
  
  RESULTS
  The prevalence of hand involvement in patients with active atopic dermatitis was 58.9% (458 of 777 patients). Nail dystrophy was present in 16% (124 of 777) of patients. There was a significant trend toward an increasing prevalence of hand involvement with increasing age. Hand eczema tended to involve primarily the dorsal hand surfaces and the volar wrist.
  
  
  CONCLUSIONS
  The hands are frequently involved in patients with active atopic dermatitis and present unique physical, social, and therapeutic challenges for patients. During the evaluation of patients presenting with hand eczema, the involvement of dorsal hand surfaces and the volar wrist may suggest atopic dermatitis as a contributing etiologic factor.
authors.affiliation: Department of Dermatology, Oregon Health and Science University, Portland, OR, USA.
authors.forename: Eric L
authors.initials: EL
authors.lastname: Simpson
authors.forename: Michele M
authors.initials: MM
authors.lastname: Thompson
authors.forename: Jon M
authors.initials: JM
authors.lastname: Hanifin
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D004485:Eczema / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D005260:Female; D006229:Hand Dermatoses / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009922:Oregon / Q000453:epidemiology; D015995:Prevalence; D012720:Severity of Illness Index