title: Allergens associated with severe symptoms of hand eczema and a poor prognosis.
abstract: BACKGROUND
  Contact allergy is frequent among persons with hand eczema and may be associated with a poor prognosis.
  
  
  OBJECTIVE
  To identify allergens associated with the most severe initial clinical symptoms and the worst prognosis in a cohort of hand eczema patients followed for 6 months.
  
  
  METHODS
  The study population comprised 799 consecutive hand eczema patients enrolled during January 2006-February 2007. All patients were patch tested with the European baseline series. Severity assessment of the hand eczema was performed initially and at the 6-month follow-up using a validated scoring system (HECSI). With logistic regression analyses, associations of severe hand eczema or a poor prognosis with 15 individual allergens were analysed and adjusted for by sex, age, atopic dermatitis and other allergens.
  
  
  RESULTS
  At baseline, greater severity of hand eczema was associated with a positive patch test to formaldehyde, methyldibromo glutaronitrile, sesquiterpene lactone mix, nickel sulfate and potassium dichromate. A poor prognosis was associated with chromate allergy, odds ratio: 4.18 (95% CI: 1.42-12.28).
  
  
  CONCLUSIONS
  Nickel, chromate, formaldehyde, methyldibromo glutaronitrile and sesquiterpene lactone mix were allergens associated with the greatest severity of hand eczema. Patients with chromate allergy had the worst prognosis.
authors.affiliation: The National Allergy Research Centre, Department of Dermato-allergology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. marhal02@geh.regionh.dk
authors.forename: Marianne
authors.initials: M
authors.lastname: Hald
authors.forename: Tove
authors.initials: T
authors.lastname: Agner
authors.forename: Jette
authors.initials: J
authors.lastname: Blands
authors.forename: Henrik
authors.initials: H
authors.lastname: Ravn
authors.forename: Jean Duus
authors.initials: JD
authors.lastname: Johansen
mesh_terms: D000328:Adult; D000485:Allergens / Q000633:toxicity*; D016009:Chi-Square Distribution; D004485:Eczema / Q000139:chemically induced*; D005260:Female; D006229:Hand Dermatoses / Q000139:chemically induced*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010328:Patch Tests; D010781:Photography; D011379:Prognosis; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D000485:Allergens