Hand eczema and atopic dermatitis in adolescents: a prospective cohort study from the BAMSE project

Grönhagen, Carina M; Lidén, Carola; Wahlgren, Carl-Fredrik; Ballardini, Natalia; Bergström, Anna; Kull, Inger; Meding, Birgitta

doi:10.1111/bjd.14019

Cited by 44 publications

(59 citation statements)

References 34 publications

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“…Although not all people with contact hand eczema have AD, people with AD are prone to hand eczema when they have 'wet' jobs that require handling irritating substances. Thus, it is of great interest to scale up occupational education and prevention measures in this group [25]. Additionally, Williams et al [27] have described cases of occupational contact dermatitis that interact with atopy to cause endogenous-like eczema, even in people who have been asymptomatic since childhood [12,15].…”

Section: Clinical Patternsmentioning

confidence: 99%

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Atopic Dermatitis in Adults: A Diagnostic Challenge

Salvador¹,

Romero‐Pérez²,

Encabo-Durán³

2017

J Investig Allergol Clin Immunol

150

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Atopic dermatitis (AD) has a prevalence of 1%-3% in adults. Adult-onset AD has only been defined recently, and lack of familiarity with this condition and confusion regarding the appropriate terminology persist. AD may first appear in childhood or de novo in adults and is characterized by pronounced clinical heterogeneity. The disease often deviates from the classic pattern of flexural dermatitis, and there are forms of presentation that are specific to adults, such as head-and-neck dermatitis, chronic eczema of the hands, multiple areas of lichenification, or prurigo lesions. Although diagnosis is clinical, adult-onset AD frequently does not fit the traditional diagnostic criteria for the disease, which were developed for children. Thus, AD is often a diagnosis of exclusion, especially in de novo cases. Additional diagnostic tests, such as the patch test, prick test, skin biopsy, or blood test, are usually necessary to rule out other diseases or other types of eczema appearing concomitantly with AD. This article presents an update of the different forms of clinical presentation for AD in adults along with a proposed diagnostic approach, as new treatments will appear in the near future and many patients will not be able to benefit from them unless they are properly diagnosed. Key words: Atopic dermatitis. Adult. Diagnosis. Patch testing. Prick testing. ResumenLa dermatitis atópica (DA) en el adulto tiene una prevalencia del 1-3%. Es una entidad de reciente acuñamiento, que no todo el mundo conoce y sobre la que existe una gran confusión terminológica. Puede iniciarse en la infancia o presentarse de "novo" en el adulto. Presenta una gran heterogeneidad clínica y con frecuencia no sigue el patrón clásico de dermatitis flexural. Además, existen formas de presentación más propias de adulto como son la dermatitis de la cabeza y el cuello, eczema crónico de manos, áreas de liquenificación múltiple o lesiones de prurigo. Aunque su diagnóstico es clínico, muchas veces la DA del adulto no cumple los criterios diagnósticos "clásicos" de DA, pues están pensados para niños. Por eso, suele ser un diagnóstico de exclusión, sobre todo los casos de "novo". Suele precisar de la realización de pruebas diagnósticas para descartar otras enfermedades distintas u otro tipo de eczema sobreañadido a la DA. Las pruebas diagnósticas que pueden resultar útiles para ello son: pruebas epicutáneas, prick test, biopsia cutánea y una analítica sanguínea. Realizamos una actualización de las distintas formas de presentación clínica de la DA del adulto y establecemos unas pautas para llegar a su diagnóstico, pues en un futuro inmediato, con la aparición de nuevos tratamientos, muchos de estos pacientes no podrán beneficiarse de los mismos por no estar adecuadamente diagnosticados. Palabras clave: Dermatitis atópica. Adulto. Diagnóstico. Pruebas epicutáneas. Prick test.

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Section: Clinical Patternsmentioning

confidence: 99%

“…Likewise, AD [25,[29][30][31]. Thus, the presence of chronic hand eczema in adults should always raise the suspicion of adult AD.…”

Section: Hand Eczemamentioning

confidence: 99%

Atopic Dermatitis in Adults: A Diagnostic Challenge

Salvador¹,

Romero‐Pérez²,

Encabo-Durán³

2017

J Investig Allergol Clin Immunol

150

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“…In 1985, Rystedt showed that patients with persistent or recurrent AD had a significantly higher risk of having hand eczema in adulthood . This association has later been confirmed in various studies, most recently in prospective cohorts of adolescence from the general population . Other risk factors for hand eczema include female sex, contact allergy, wet work, xerosis and tobacco smoking .…”

mentioning

confidence: 91%

“…Most recent studies investigating predictors of hand eczema in the general population have focused on adolescents . Thus, research focusing on predictors of hand eczema in the adult general population is warranted.…”

mentioning

confidence: 99%

Predictive factors of self-reported hand eczema in adult Danes: a population-based cohort study with 5-year follow-up

et al. 2016

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SummaryBackground Information about predictive factors of hand eczema is crucial for primary prevention. Objectives To investigate predictive factors of hand eczema in adult Danes from the general population. Methods Participants from a cross-sectional 5-year follow-up study in the general population, aged 18-72 years (n = 2270), completed questionnaires about skin health and were grouped into four hand eczema groups: 'never', 'incident', 'nonpersistent' and 'persistent'. Multiple logistic regression models adjusted for age group and sex were used to evaluate associations with baseline variables. The participation rate for the follow-up study was 66Á5% (29Á7% of the participants originally invited to the baseline study). Results A history of atopic dermatitis (AD) was associated with both persistent and incident hand eczema [odds ratio (OR) 9Á0, 95% confidence interval (95% CI) 5Á6-14Á4 and OR 3Á0, 95% CI 1Á7-5Á2, respectively]. Thus, even in adulthood, a history of AD should be considered as a predictor of incident hand eczema. While filaggrin gene (FLG) null mutations were not associated with incident hand eczema, a statistically significant association was observed with persistent hand eczema (OR 3Á1, 95% CI 1Á8-5Á2). Finally, contact sensitization (23 allergens without nickel) was also associated with persistent hand eczema (OR 2Á5, 95% CI 1Á2-5Á0), independently of a history of AD. Conclusions This study confirms a history of AD as the strongest predictor of persistent hand eczema. We additionally found that a history of AD was associated with incident hand eczema in adults, in contrast to FLG mutations, which were associated only with persistent hand eczema in individuals with a history of AD, and not with incident hand eczema. Our study adds new knowledge to the interplay between AD, FLG mutations and hand eczema in the adult general population.

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“…All children who play with homemade slime should be advised to rinse their hands thoroughly with water and apply a lipophilic or ceramide‐containing emollient after contact. We advise children with moderate to severe atopic dermatitis in our practice to avoid direct contact with homemade slime because of their risk of development of hand eczema . If needed for dermatitis, topical steroids can be prescribed, although their clinical efficacy is unclear for this condition .…”

Section: Discussionmentioning

confidence: 99%

A slime of the times: Two cases of acute irritant contact dermatitis from homemade slime

Heller

Murthy

Jen

2018

Pediatric Dermatology

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We describe two cases of acute-onset erythema, peeling, and pruritus or tenderness isolated to the palmar surface of the hands. A detailed exposure history revealed significant periods of contact with homemade slime; given the clinical findings and timing of exposure, acute contact dermatitis of the hands was suspected. Symptoms and clinical findings resolved after avoidance of the suspected causative contactants. There are few if any reported cases of contact dermatitis to homemade slime in the literature; this serves to highlight the importance of a thorough exposure history in the evaluation of hand dermatitis.

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Hand eczema and atopic dermatitis in adolescents: a prospective cohort study from the BAMSE project

Cited by 44 publications

References 34 publications

Atopic Dermatitis in Adults: A Diagnostic Challenge

Atopic Dermatitis in Adults: A Diagnostic Challenge

Predictive factors of self-reported hand eczema in adult Danes: a population-based cohort study with 5-year follow-up

A slime of the times: Two cases of acute irritant contact dermatitis from homemade slime

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