Allergic contact dermatitis in hand eczema: a clinico-etiological study

Talat Masood Akbar, Muhammad Nadeem, T.S. Haroon


Objective To identify the various morphological types of hand eczema and to detect the common etiological sensitizers in our community by patch testing, and attempt to correlate them.


Methods One hundred patients of hand eczema presenting to the department of dermatology, Mayo hospital, were enrolled in the research study after informed consent. After taking a careful history and complete examination, they were classified according to clinical presentation, and patch tested with European standard series. Patches were applied to the upper back in accordance with the principles of patch testing. Results were read at 48, 72 and 120 hours after removal of patches, and interpreted according to the International Contact Dermatitis Research Group criteria. Data was analyzed and interpreted.


Results Patch testing results indicated that 46% of patients had positive allergic reactions. The commonest allergens detected were nickel (21%), chromate (13%), neomycin (12%) and cobalt (11%). Nickel sensitivity was more common in females (19%), while chromate was more common in males (11%). Attempt at clinicoetiological correlation showed few patterns, as different allergens could cause various morphological presentations. However, nickel sensitivity was noted in ring eczema (75%) and pompholyx (44%), while no allergens were detected in apron and hyperkeratotic palmar eczema.


Conclusion A high allergic sensitivity (46%) was noted in our patients of hand eczema. Different allergens could cause varied morphology and no specific clinicoetiological patterns can be defined. Therefore, a patch test should essentially be done in all hand eczema patients, to detect an etiological allergen and for directing better management of our patients.



Hand eczema, allergic contact dermatitis, patch test, European Standard series

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