Chronic Hand Eczema, learning from clinical characterization, aetiology, concomitant foot eczema and polysensitization

Supplementary data for the publication: Chronic Hand Eczema, learning from clinical characterization, aetiology, concomitant foot eczema and polysensitization. Summary: Background. Chronic hand eczema (CHE) is a disabling dermatosis that shows concomitant conditions, such as foot eczema and contact sensitization. Objectives. To identify the characteristics of CHE population in Spain: with special emphasis on occupational dermatitis, evaluation of concomitant foot eczema and of polysensitization phenomenon.Methods. 2,926 patch-tested patients presenting CHE from different specialized Dermatological Units were evaluated. A global descriptive characterization was performed for different subgroups, as well as an evaluation of polysensitization. Results. The first diagnostic for CHE was irritant contact dermatitis (42%) and for patients with foot-and-chronic hand eczema (FCHE) it was allergic contact dermatitis (28%). A 39% of CHE showed occupational relevance. Positivity for at least one allergen was found in 55% of patients, with nickel sulphate and methylisothiazolinone (MI) as the most prevalent. Methylchloroisothiazolinone (MCI)/MI, nickel sulphate and potassium dichromate showed the highest occupational relevance. 236 cases presented concomitant FCHE (8%, 46% men) with higher percentages of positivity for potassium dichromate and cobalt chloride. Twelve percent of patients with CHE were polysensitized, with MI as the most frequent allergen. Conclusions. Patch test for FCHE and CHE shows a specific contact allergen and occupational profile. Methylisothiazolinone appeared as the most related allergen to polysensitization in CHE.学术论文补充数据：慢性手部湿疹——基于临床表征、病因学、合并足部湿疹与多敏化现象的研究 摘要： 背景：慢性手部湿疹（Chronic Hand Eczema, CHE）是一种致残性皮肤病，常伴随足部湿疹、接触性致敏等合并病症。 研究目标：明确西班牙慢性手部湿疹患者群体的特征，重点关注职业性皮炎、合并足部湿疹情况及多敏化现象。 研究方法：纳入来自不同专科皮肤科诊疗单元的2926名确诊慢性手部湿疹且接受斑贴试验的患者，对不同亚组开展全面描述性特征分析，并对多敏化现象进行评估。 研究结果：慢性手部湿疹的首要诊断类型为刺激性接触性皮炎（占比42%）；合并足部湿疹的慢性手部湿疹（Foot-and-Chronic Hand Eczema, FCHE）患者的首要诊断则为变应性接触性皮炎（占比28%）。39%的慢性手部湿疹病例具有职业相关性。55%的患者至少对一种变应原呈阳性反应，其中以硫酸镍和甲基异噻唑啉酮（Methylisothiazolinone, MI）最为常见。甲基氯异噻唑啉酮/甲基异噻唑啉酮（Methylchloroisothiazolinone/MI, MCI/MI）、硫酸镍及重铬酸钾表现出最高的职业相关性。共236例患者合并FCHE（占比8%，其中男性占比46%），其重铬酸钾与氯化钴的阳性率更高。12%的慢性手部湿疹患者存在多敏化现象，其中MI为最常见的致敏原。 研究结论：针对合并足部湿疹的慢性手部湿疹患者开展斑贴试验，可明确其特异性接触致敏原与职业暴露特征。甲基异噻唑啉酮是慢性手部湿疹患者多敏化现象关联度最高的致敏原。