title: Chronic hand eczema: is IL-36α helpful in diagnosis and classification?
abstract: BACKGROUND
  Chronic hand eczema (CHE) is not a homogenous disease, necessitating complex differential diagnostics. Interleukin (IL) -1 family members are significantly up-regulated in ACD and psoriasis patients skin.
  
  
  METHODS
  The present study aims to deepen the knowledge about clinical assessment and characterization of patients affected by chronic hand dermatitis (CHD) as well as to investigate the role of possible biomarkers which may help in the diagnostic process. An observational case-control study was performed enrolling 30 CHD patients and 20 healthy controls. Each patient underwent detailed medical history, clinical examination, epicutaneous patch test, and lesional skin biopsies for histological and immunohistochemical analysis.
  
  
  RESULTS
  Patient history, clinical examination and patch testing led us to a final CHD characterization in only 8/30 subjects (26.7%). In the remaining subjects, clinical and histological features suggested a diagnosis of psoriasis in 9/22 (30%) and idiopathic chronic hand eczema (CHE) in 13/22 (43.3%). Trying to find a possible marker for the latter dermatosis, we analyzed IL-1 family in all the recruited subjects. IL-1 members were increased in all conditions, but IL-36α was the only analyzed cytokine able to characterize patients who end up with a diagnosis of idiopathic CHE.
  
  
  CONCLUSIONS
  In conclusion, we can assess that medical history and patch testing remain essential investigations in CHD patients even if not always sufficient to perform a final diagnosis. Moreover, IL-1 members are probably involved in CHE skin inflammation, with IL-36α being a possible future biomarker which might help in the complex diagnostic process of CHE.
authors.affiliation: Department of Dermatology, Federico II University, Naples, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Schiattarella
authors.affiliation: Department of Dermatology, Federico II University, Naples, Italy.
authors.forename: Cataldo
authors.initials: C
authors.lastname: Patruno
authors.affiliation: Department of Dermatology, Federico II University, Naples, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Balato
authors.affiliation: Department of Plastic Surgery, Federico II University, Naples, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Canta
authors.affiliation: Department of Dermatology, Federico II University, Naples, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Caiazzo
authors.affiliation: Department of Dermatology, Federico II University, Naples, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Lembo
authors.affiliation: Department of Dermatology, Federico II University, Naples, Italy - mat24@libero.it.
authors.forename: Matteo
authors.initials: M
authors.lastname: Megna
authors.affiliation: Department of Dermatology, Federico II University, Naples, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Ayala
authors.affiliation: Department of Dermatology, Federico II University, Naples, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Balato
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D001706:Biopsy; D016022:Case-Control Studies; D002908:Chronic Disease; D016207:Cytokines / Q000378:metabolism; D003937:Diagnosis, Differential; D004485:Eczema / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006229:Hand Dermatoses / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007375:Interleukin-1 / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010328:Patch Tests; D011446:Prospective Studies; D011565:Psoriasis / Q000175:diagnosis* / Q000473:pathology
chemical_list: D015415:Biomarkers; D016207:Cytokines; C508586:IL36A protein, human; D007375:Interleukin-1