Occupational Exposures Implicated in More Than Half of Chronic Hand Eczema Cases
Key Takeaways
- In a retrospective cohort of 76 adults with chronic hand eczema (CHE), allergic contact dermatitis was the most common etiology, diagnosed in 57.9% of patients.
- Occupational CHE was identified in 52.6% of the cohort, with health and laboratory workers and cleaning personnel among the most commonly represented occupations.
- After diagnosis and treatment recommendations, including allergen avoidance, 93% of patients experienced full or partial improvement.
A new retrospective study of adults with chronic hand eczema (CHE) found allergic contact dermatitis (ACD) and occupational exposures were common, while most patients improved following diagnosis and treatment recommendations that included allergen avoidance.
Investigators evaluated 76 adults seen in the Allergy Department at Clínica Universidad de Navarra in Spain between January 2021 and December 2023. Patients underwent patch testing with the Spanish GEIDAC series, supplemented by specific allergens and personal products when appropriate. The cohort had a mean age of 39.4 years, and 69.7% were women. Atopy (defined as atopic dermatitis, allergic rhinitis, or asthma) was present in 36.8% of participants.
Patch Testing Identifies Relevant Allergens in Chronic Hand Eczema
According to the results, ACD was diagnosed in 57.9% of patients, followed by irritant contact dermatitis in 35.5%. Patch testing showed that 61.8% of sensitizations were considered clinically relevant. Kathon was the most frequently identified sensitization at 14.9%, followed by nickel, thiuram mix, and balsam of Peru, each at 12.8%. Nearly 30% of patients had multiple relevant sensitizations.
Occupational CHE was identified in 52.6% of patients. Health and laboratory workers accounted for 19.7% of the cohort and cleaning personnel for 9.2%. Median latency for occupational CHE was 32 months. Patients with atopy had a numerically shorter latency than those without atopy (6.5 vs 65.5 months), but the difference did not reach statistical significance (P = 0.0744).
Following treatment and recommendations, including allergen avoidance, 63.0% of patients achieved full improvement and 29.6% achieved partial improvement. Study limitations included the heterogeneous referral population, possible overestimation of occupational CHE and atopy, and incomplete use of the Hand Eczema Severity Index.
“Advancing CHE management requires targeted interventions, further research, standardized data collection, and multicenter studies,” the authors wrote.
Source
Sanchez-Fernandez S, et al. Allergology International. 2026. Doi:10.1016/j.alit.2026.03.002