The reproducibility of the pulsed ultrasound technique for the determination of skin thickness was investigated, using two independent observers. No systematic difference was found and a high correlation was obtained. Studies were also undertaken to validate the pulsed ultrasound technique as a measure of true skin thickness. Skin thickness determined in vitro was found to be greater than when in vivo determinations were made by either the pulsed ultrasound or a xeroradiographic technique, probably due to the release of in vivo tension within the dermis after excision. Skin thickness was found to increase linearly with age up to the age of 20 years and to decrease linearly with age subsequently. Differences in skin thickness between the sexes and in different sites of the body were demonstrated.

While a number of allergens shows limited variation across the four regions, such as Myroxylon pereirae (5.3-6.8%), cobalt chloride (6.2-8.8%) or thiuram mix (1.7-2.4%), the differences observed with other allergens may hint on underlying differences in exposures, for example: dichromate 2.4% in the UK (west) versus 4.5-5.9% in the remaining EU regions, methylchloroisothiazolinone/methylisothiazolinone 4.1% in the South versus 2.1-2.7% in the remaining regions. Conclusions: Notwithstanding residual methodological variation (affecting at least some 'difficult' allergens) tackled by ongoing efforts for standardization, a comparative analysis as presented provides (i) a broad overview on contact allergy frequencies and (ii) interesting starting points for further, in-depth investigation.

Background. The pattern of contact sensitization to the supposedly most important allergens assembled in the baseline series differs between countries, presumably at least partly because of exposure differences. Objectives. To describe the prevalence of contact sensitization to allergens tested in consecutive patients in the years 2007 and 2008, and to discuss possible differences. Methods. Data from the 39 departments in 11 European countries comprising the European Surveillance System on Contact Allergy network (http://www.essca-dc.org) in this period have been pooled and analysed according to common standards. Results. Patch test results with the European baseline series, and country‐specific or department‐specific additions to it, obtained in 25 181 patients, showed marked international variation. Metals and fragrances are still the most frequent allergens across Europe. Some allergens tested nationally may be useful future additions to the European baseline series, for example methylisothiazolinone, whereas a few long‐term components of the European baseline series, namely primin and clioquinol, no longer warrant routine testing. Conclusions. The present analysis points to ‘excess’ prevalences of specific contact sensitization in some countries, although interpretation must be cautious if only few, and possibly specialized, centres are representing one country. A comparison as presented may help to target in‐depth research into possible causes of ‘excess’ exposure, and/or consideration of methodological issues, including modifications to the baseline series.

The reproducibility of the pulsed ultrasound technique for the determination of skin thickness was investigated, using two independent observers. No systematic difference was found and a high correlation was obtained. Studies were also undertaken to validate the pulsed ultrasound technique as a measure of true skin thickness. Skin thickness determined in vitro was found to be greater than when in vivo determinations were made by either the pulsed ultrasound or a xeroradiographic technique, probably due to the release of in vivo tension within the dermis after excision. Skin thickness was found to increase linearly with age up to the age of 20 years and to decrease linearly with age subsequently. Differences in skin thickness between the sexes and in different sites of the body were demonstrated.

The management of chronic hand eczema is often inadequate. There are currently no evidence-based guidelines specifically for the management of chronic hand eczema, and evidence for established treatments for hand eczema is not of sufficient quality to guide clinical practice. This consensus statement, based on a review of published data and clinical practice in both primary and secondary care, is intended to guide the management of chronic hand eczema. It describes the epidemiology and pathogenesis of hand eczema, its diagnosis and its effect on patients' quality of life. Management strategies include a skin education programme, lifestyle changes, and the use of emollients, barriers and soap substitutes. Topical drug therapy includes topical steroids and calcineurin inhibitors. Treatment with psoralen ultraviolet A and systemic therapies may then be appropriate, although there is no strong evidence of efficacy. Alitretinoin has been shown to be effective in a randomized controlled trial, and is currently the only treatment specifically licensed for the treatment of hand eczema. Recommendations for management are summarized in a treatment algorithm.