Contact dermatitis of the hands: cross-sectional analyses of North American Contact Dermatitis Group Data, 1994-2004.
BACKGROUND
Hand dermatitis, including irritant and allergic contact dermatitis (ACD), is common.


OBJECTIVE
To evaluate allergens, relevant irritants, sources and occupations associated with hand contact dermatitis using North American Contact Dermatitis Group (NACDG) data.


METHODS
A cross-sectional analysis of 22,025 patients patch tested between 1994 and 2004.


RESULTS
Hand involvement was found in 6953 patients; 959 had ACD as the only diagnosis. In these 959 patients, the 12 most frequent relevant allergens were quaternium-15 (16.5%), formaldehyde (13.0%), nickel sulfate (12.2%), fragrance mix (11.3%), thiuram mix (10.2%), balsam of Peru (9.6%), carba mix (7.8%), neomycin sulfate (7.7%), bacitracin (7.4%), methyldibromoglutaronitrile/phenoxyethanol 2.0% (7.4%), cobalt chloride (6.5%), and methyldibromoglutaronitrile/phenoxyethanol 2.5% (6.3%). Rubber allergens were most commonly associated with occupation. One third of patients with hand ACD had identifiable relevant irritants.


CONCLUSIONS
Cross-sectional analyses prevent evaluation of causal associations.


CONCLUSIONS
In NACDG patients with hand ACD, the most common allergens included preservatives, metals, fragrances, topical antibiotics, and rubber additives.
Warshaw
Erin M
EM
Department of Dermatology, Veterans Affairs Medical Center, Minneapolis, MN 55417, USA. erin.warshaw@med.va.gov
Ahmed
Rehana L
RL
Belsito
Donald V
DV
DeLeo
Vincent A
VA
Fowler
Joseph F
JF
Maibach
Howard I
HI
Marks
James G
JG
Toby Mathias
C G
CG
Pratt
Melanie D
MD
Rietschel
Robert L
RL
Sasseville
Denis
D
Storrs
Frances J
FJ
Taylor
James S
JS
Zug
Kathryn A
KA
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000485:Allergens / Q000276:immunology; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003877:Dermatitis, Contact / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology; D017453:Dermatitis, Irritant / Q000209:etiology; D005260:Female; D006229:Hand Dermatoses / Q000139:chemically induced* / Q000453:epidemiology / Q000276:immunology*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008670:Metals / Q000009:adverse effects; D008875:Middle Aged; D016273:Occupational Exposure; D010476:Perfume / Q000009:adverse effects; D011310:Preservatives, Pharmaceutical / Q000009:adverse effects; D012408:Rubber
D000485:Allergens; D000900:Anti-Bacterial Agents; D008670:Metals; D010476:Perfume; D011310:Preservatives, Pharmaceutical; D012408:Rubber