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Hand dermatitis in adults referred for patch testing: Analysis of North American Contact Dermatitis Group Data, 2000 to 2016 - 10/03/21

Doi : 10.1016/j.jaad.2020.11.054 
Jonathan I. Silverberg, MD a, b, , Erin M. Warshaw, MD, MS c, d, e, Amber R. Atwater, MD f, Howard I. Maibach, MD g, Kathryn A. Zug, MD h, Margo J. Reeder, MD i, Denis Sasseville, MD j, James S. Taylor, MD k, Joseph F. Fowler, MD l, Melanie D. Pratt, MD m, Anthony F. Fransway, MD n, Matthew J. Zirwas, MD o, Donald V. Belsito, MD p, James G. Marks, MD q, Vincent A. DeLeo, MD r, Joel G. DeKoven, MD s
a Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC 
b Department of Dermatology, the Northwestern University Feinberg School of Medicine, Chicago, Illinois 
c Department of Dermatology, Park Nicollet Health Services, Minneapolis, Minnesota 
d Department of Dermatology, University of Minnesota, Minneapolis, Minnesota 
e Department of Dermatology, Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota 
f Department of Dermatology, Duke University Medical Center, Durham, North Carolina 
g Department of Dermatology, University of California San Francisco, San Francisco, California 
h Department of Dermatology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 
i Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 
j Division of Dermatology, Montreal General Hospital, McGill University, Montreal, Canada 
k Department of Dermatology, Cleveland Clinic, Cleveland, Ohio 
l Division of Dermatology University of Louisville, Louisville, Kentucky 
m Division of Dermatology, University of Ottawa, Ottawa, Canada 
n Associates in Dermatology, Fort Myers, Florida 
o Department of Dermatology, Ohio State University, Columbus, Ohio 
p Department of Dermatology, Columbia University, New York, New York 
q Department of Dermatology, Pennsylvania State University, State College, Pennsylvania 
r Department of Dermatology, Keck School of Medicine, Los Angeles, California 
s Division of Dermatology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada 

Correspondence to: Jonathan I. Silverberg, MD, George Washington University School of Medicine and Health Sciences, Department of Dermatology, Suite 2B-425, 2150 Pennsylvania Avenue NW, Washington, DC 20037.George Washington University School of Medicine and Health SciencesDepartment of DermatologySuite 2B-425, 2150 Pennsylvania Avenue NWWashingtonDC20037

Abstract

Background

Hand eczema (HE) is a heterogeneous and burdensome disorder.

Objective

To characterize the clinical characteristics, etiologies and allergen relevance in adults with HE referred for patch testing.

Methods

Retrospective analysis (2000-2016) of North American Contact Dermatitis Group data (n = 37,113).

Results

Overall, 10,034 patients had HE, with differences of overlap between allergic contact, irritant contact, and atopic dermatitis. Allergic contact HE fluctuated, whereas atopic HE steadily increased, and irritant HE decreased over time. HE was associated with higher proportions of positive patch tests (67.5% vs 63.8%; χ2, P < .0001). The five most common clinically relevant allergens were methylisothiazolinone, nickel, formaldehyde, quaternium-15, and fragrance mix I. HE was associated with significantly higher odds of positive patch test reactions and clinical relevance in 13 and 16 of the 25 most common allergens, respectively, including preservatives, metals, topical medications, and rubber accelerators.

Limitations

No data on HE phenotype.

Conclusion

HE in adults was associated with higher proportions of positive patch tests, with a heterogeneous profile of allergens. Patch testing remains an important tool in the evaluation of patients with HE.

Le texte complet de cet article est disponible en PDF.

Key words : allergic contact dermatitis, arm, atopic dermatitis, contact allergy, eczema, foot, hand, irritant contact dermatitis

Abbreviations used : ACHE, ACD, AD, AHE, HE, ICD, ICHE, NACDG, SPIN


Plan


 Funding sources: None.
 IRB approval status: Approved by the institutional review board of Northwestern University.
 This study was supported by resources and use of facilities at the Minneapolis Veterans Affairs Medical Center. The contents do not represent the views of the U.S. Department of Veterans Affairs or the U.S. Government.


© 2020  American Academy of Dermatology, Inc. Tous droits réservés.
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Vol 84 - N° 4

P. 989-999 - avril 2021 Retour au numéro
Article précédent Article précédent
  • Scalp involvement in patients referred for patch testing: Retrospective cross-sectional analysis of North American Contact Dermatitis Group data, 1996 to 2016
  • Erin M. Warshaw, Sara A. Kullberg, Joel G. DeKoven, Howard I. Maibach, Donald V. Belsito, Jonathan I. Silverberg, Joseph F. Fowler, Amber R. Atwater, Denis Sasseville, Margo J. Reeder, James S. Taylor, Vincent A. DeLeo, Melanie D. Pratt, Kathryn A. Zug, Anthony F. Fransway
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