Patients with atopic dermatitis (AD) had a strongly increased prevalence of hand eczema (HE), according to a recent systematic review and meta-analysis. To that end, clinicians should continue to guide patients with AD away from occupations with high risk of HE. Researchers systematically reviewed published literature on the association between AD and HE using the following search terms: (atopic dermatitis OR atopic eczema) AND (hand dermatitis OR hand eczema). Meta-analyses were then performed to examine the association between AD and the point-, 1-year-, and lifetime prevalence of HE, respectively. They identified 35 relevant studies, of which 26 were included in the meta-analyses, and found:
- AD was associated with an increased prevalence of HE with regards to point-, 1-year-, and lifetime prevalence.
- Furthermore, positive associations between AD and occupational HE were identified when assessing the 1-year- and lifetime prevalence.
- Similar positive associations were found in the general population studies.
Ruff SMD, Engebretsen KA, Zachariae C, et al. The association between atopic dermatitis and hand eczema: A systematic review and meta-analysis. [Published online ahead of print November 24, 2017]. Br J Dermatol. doi:10.1111/bjd.16147.
A fair number of atopic individuals will "grow out of" the classic manifestations of childhood AD as they approach adulthood. Regardless of this, these individuals are still at greatly increased risk of developing hand eczema at any age. This is also true, to a lesser degree, in patients with respiratory atopy without skin disease. This is seen particularly in persons in "wet-work" occupations such as health care, food service, etc. Some data suggest that allergic contact dermatitis occurs more commonly in atopics, which can be diagnosed with appropriate patch testing. Counseling the young atopic patient and caregivers to avoid exposure of the hands to common allergens and irritants, as well as to avoid jobs which require "wet-work" exposure may be a good idea.
—Dr. Joseph Fowler, MD
Clinical Professor of Dermatology, University of Louisville, KY
Assistant Clinical Professor, Division of Occupational Medicine, University of Kentucky, KY
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