title: Hand eczema: correlation of morphologic patterns, atopy, contact sensitization and disease severity.
abstract: BACKGROUND
  Hand eczema is a common distressing condition aggravated by a number of endogenous and exogenous factors. Various morphological forms of hand eczema have been described, but categorization into one of them is not always possible.
  
  
  OBJECTIVE
  To study the morphological patterns of hand eczema, relationship of atopy with hand eczema, and the implications of contact sensitization with respect to severity and diagnosis of hand eczema.
  
  
  METHODS
  Hundred consecutive patients of hand eczema attending the contact dermatitis clinic of the institute were recruited over a two year period from 2004-05. Objective assessment was done using hand eczema severity index (HECSI) and all the patients were patch tested using Indian standard series.
  
  
  RESULTS
  Unspecified type of hand eczema with no definite morphologic picture was seen in 62% followed by pompholyx in 14%. Hand eczema severity was not found to be statistically associated with age, sex, and atopic status of the patient. Positive patch test to one or more allergen was present in 65% of patients. The most common allergens were potassium dichromate (25%), fragrance mix (16%), nickel sulphate (14%), and PPD (13%). There was no significant correlation between patch test positivity and hand eczema severity or atopic status of the patient. Among the morphological patterns pompholyx was strongly associated with an atopic status (P=0.004).
  
  
  CONCLUSIONS
  Hand eczema was seen twice more commonly in men. Atopic and non-atopic patients of hand eczema had no difference in the severity of disease. Contact sensitivity to different allergens did not correlate with increased eczema severity.
authors.affiliation: Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. handa_sanjeev@yahoo.com
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Handa
authors.forename: Inderjit
authors.initials: I
authors.lastname: Kaur
authors.forename: Tarun
authors.initials: T
authors.lastname: Gupta
authors.forename: Rashmi
authors.initials: R
authors.lastname: Jindal
mesh_terms: D000293:Adolescent; D000328:Adult; D017449:Dermatitis, Allergic Contact / Q000453:epidemiology / Q000473:pathology*; D003876:Dermatitis, Atopic / Q000453:epidemiology / Q000473:pathology*; D004485:Eczema / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D005385:Fingers / Q000473:pathology; D006229:Hand Dermatoses / Q000453:epidemiology / Q000473:pathology*; D006795:Household Products / Q000009:adverse effects; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D055815:Young Adult