Hand Eczema

Abstract

Hand eczema is a common disease in the general population and even more common in specific occupations where hands are intensively exposed to irritants and allergens. More than 15% of the population is affected during their lifetime, females are more often affected than males, and in most cases the disease has its onset early in life. The etiology for HE is multifactorial and includes environmental exposures as well as genetic factors. For many years the focus was allergic contact dermatitis, identifying relevant allergens in the local environment of patients; however today the importance of irritant contact dermatitis, either as the primary reason or as a deteriorating factor complicating allergic, atopic or other clinical subtypes of eczema, is better understood. The prognosis for HE is discouraging, the eczema may persist for more than a decade with either chronic signs or frequent flares. Consequences of the disease are far reaching. Health-related quality of life is markedly reduced, working capacity is impaired, and for society the economic consequences are significant. However, since HE is related to exposure the preventive potential is significant. Nevertheless, despite preventive measures being attempted, the prevalence of HE in the general population seems unchanged over the last decades.

The objective of this review is to give an update on HE regarding epidemiology, classification and risk factors, to deepen the current understanding of the development of irritant contact dermatitis, and to focus on evidence-based prevention and point out possible directions for future interventions regarding the prevention of HE. The article is based on current available literature, and after each of the specific sections we have summarized, concluded and highlighted issues of special importance.