title: Smoking is associated with combined allergic and irritant hand eczema, contact allergies and hyperhidrosis.
abstract: BACKGROUND
  The pathogenesis of chronic hand eczema (CHE) is multifactorial. Certain life-style factors have been suggested as potential triggers of the disease, among them tobacco smoking. However, the few studies addressing the influence of smoking on CHE have been more or less limited to occupational hand eczema.
  
  
  OBJECTIVE
  The aim of our study was to investigate the association of smoking status with clinical features like contact sensitization, irritant exposure, atopy and hyperhidrosis in a thoroughly characterized cohort of CHE patients.
  
  
  METHODS
  A total of 153 patients with CHE underwent clinical examination and an interview about their history and course of disease.
  
  
  RESULTS
  Significantly more smokers suffered from combined allergic and irritant hand eczema (25/86) than non-smokers (7/67; P < 0.05). Nickel sensitization and palmar hyperhidrosis tended to be more frequent among smokers than among non-smokers (nickel: 17/86 smokers, 6/67 non-smokers; hyperhidrosis: 21/84 smokers, 8/64 non-smokers). Among the smoking CHE patients with palmar hyperhidrosis, a significant proportion had contact allergies relevant contact allergies (16/21, P < 0.05).
  
  
  CONCLUSIONS
  Our results reveal a predominance of smokers among patients with combined allergic and irritant hand eczema as well as with hyperhidrosis and relevant contact sensitizations.
authors.affiliation: Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Molin
authors.affiliation: Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Ruzicka
authors.affiliation: Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Herzinger
mesh_terms: D002908:Chronic Disease; D015897:Comorbidity; D017449:Dermatitis, Allergic Contact / Q000453:epidemiology*; D017453:Dermatitis, Irritant / Q000453:epidemiology*; D004485:Eczema / Q000453:epidemiology*; D005260:Female; D006229:Hand Dermatoses / Q000453:epidemiology; D006801:Humans; D006945:Hyperhidrosis / Q000453:epidemiology*; D008297:Male; D009532:Nickel / Q000276:immunology; D012907:Smoking / Q000453:epidemiology*
chemical_list: D009532:Nickel