Atopic hand dermatitis: a comparison with atopic dermatitis without hand involvement, especially with respect to influence of work and development of contact sensitization.

A group of 77 patients with atopic hand eczema were compared with 136 atopic dermatitis patients without hand manifestations. Age distribution was identical in the two groups, peaking at 25-39 years of age. Both groups were dominated by female patients. No differences existed between them with respect to atopic heredity, occurrence of other atopic manifestations, or distribution of serum IgE values. The fingers represented the predilection sites for hand involvement. Patients with hand lesions changed jobs more frequently (p less than 0.001) than those with unaffected hands, and change from a wet or unclean occupation was more common (p less than 0.001) than from a dry one. Change of work entailed improvement in the skin status of both groups. Prevalence of positive patch test reactions was high and statistically identical in both groups. Occurrence of positive responses did not explain the development of hand affliction; in only 3 patients did the test result correspond to exacerbation of the hand eczema. The number of positive reactions was high in patients with low serum IgE levels, while high levels were associated with fewer positive patch test reactions.