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PubMed2004

[Investigation of the cause of contact dermatitis due to heavy metal in a metal spray process in a film-condenser factory].

To investigate causes of contact dermatitis in the metal spray process in a film-condenser factory, we developed a questionnaire survey for workers exposed to metal dust, analyzed the metal dust, and conducted patch tests with the metal dust and its constituents. In the questionnaire survey, we identified 12 workers (12/26, 46.2%) who had had dermatitis. The main symptoms were itching, itchy red skin and itchy papules. Analysis of the metal dust showed that there was no copper oxide, but nickel, not contained in the materials of the metal spray, was detected. One worker with dermatitis had a positive reaction to 2.5% nickel sulphate. Some of the workers showed primary irritant reactions to 5% copper sulphate. As a result, we considered that these cases of dermatitis involved irritant contact dermatitis due to copper and/or allergic contact dermatitis due to nickel. To prevent dermatitis, we recommended improvement in ventilation, reducing the room temperature to reduce sweating, and to educate workers on the importance of frequent hand washing. Thereafter, the incidence of dermatitis decreased, and there were no cases requiring medication.

Adult↗
PubMed2004

Perinatal predictors of atopic dermatitis occurring in the first six months of life.

OBJECTIVE: Previous studies of predictors of atopic dermatitis have had limited sample size, small numbers of variables, or retrospective data collection. The purpose of this prospective study was to investigate several perinatal predictors of atopic dermatitis occurring in the first 6 months of life. DESIGN: We report findings from 1005 mothers and their infants participating in Project Viva, a US cohort study of pregnant women and their offspring. The main outcome measure was maternal report of a provider's diagnosis of eczema or atopic dermatitis in the first 6 months of life. We used multiple logistic regression models to assess the associations between several simultaneous predictors and incidence of atopic dermatitis. RESULTS: Cumulative incidence of atopic dermatitis in the first 6 months of life was 17.1%. Compared with infants born to white mothers, the adjusted odds ratio (OR) for risk of atopic dermatitis among infants born to black mothers was 2.41 (95% confidence interval [CI]: 1.47, 3.94) and was 2.58 among infants born to Asian mothers (95% CI: 1.27, 5.24). Male infants had an OR of 1.76 (95% CI: 1.24, 2.51). Increased gestational age at birth was a predictor (OR: 1.14; 95% CI: 1.02, 1.27, for each 1-week increment), but birth weight for gestational age was not. Infants born to mothers with a history of eczema had an OR of 2.67 (95% CI: 1.74, 4.10); paternal history of eczema also was predictive, although maternal atopic history was more predictive than paternal history. Several other perinatal, social, feeding, and environmental variables were not related to risk of atopic dermatitis. CONCLUSIONS: Black and Asian race/ethnicity, male gender, higher gestational age at birth, and family history of atopy, particularly maternal history of eczema, were associated with increased risk of atopic dermatitis in the first 6 months of life. These findings suggest that genetic and pre- and perinatal influences are important in the early presentation of this condition.

Cohort Studies↗
PubMed2004

Effects of atopic dermatitis on young American children and their families.

OBJECTIVE: The psychologic, physical, and social impact of atopic dermatitis is complex and varies among children of different ages, and the effects of atopic dermatitis on the quality of life of very young American children and their families are not well understood. This study was conducted to document these effects of atopic dermatitis on young children and their families. METHODS: Directed focus sessions were performed with parents of 26 young children with atopic dermatitis and 6 expert clinicians. Specific mentions of the ways in which atopic dermatitis affected the children and parents were reviewed, rank ordered, and categorized according to similarity in content. The categories were examined to determine the domains represented, and the domains were used to compose a conceptual framework of all of the ways that atopic dermatitis affects children and their families. RESULTS: Parents and experts mentioned a total of 181 specific quality-of-life effects. A conceptual framework, developed from the 181 effects, contains the domains of physical health, emotional health, physical functioning, and social functioning; each domain includes effects on both the child and the parents. CONCLUSIONS: Atopic dermatitis greatly affects the quality of life of afflicted children and their families. The comprehensive conceptual framework summarizes the ways in which atopic dermatitis affects the quality of life in young American children. This conceptual framework forms the basis from which quality-of-life instruments can be developed.

Child, Preschool↗
PubMed2006

Frequency of atopic dermatitis and relevance of food allergy in adults in Germany.

Many factors may aggravate atopic dermatitis. The aim of this study was to determine the frequency of atopic dermatitis in an unselected population sample and to evaluate the role of food allergy. Patients with atopic dermatitis were recruited from the population in Berlin, Germany, using a postal questionnaire. Skin prick tests for allergens were performed, followed by food challenges. A total of 1739 questionnaires was returned. In all, 23.5% of patients stated that they had atopic dermatitis, and 146 persons (8.4%) fulfilled our atopic dermatitis criteria after a detailed telephone interview. Of these, 111 were examined, and 28 (1.6%) were identified as currently suffering from atopic dermatitis. Twenty-seven patients were further evaluated: 9/27 were found to be skin prick test negative, 19/27 were skin prick test positive either to pollen and/or food allergens. Nine of 27 were challenged with the suspected food allergen: 1/9 showed a worsening of the eczema, 3/9 had oral symptoms, and 5/9 were negative. In conclusion, only 20% of adults with a positive history of atopic dermatitis show active eczema lesions at a given time point. The data indicate that most individuals with atopic dermatitis were sensitized against pollen allergens and according to that, pollen-associated food allergens. A non-selected AD patient cohort does not frequently suffer from clinically relevant pollen-associated food allergy.

Adolescent↗
PubMedDate not supplied

Relevance of patch testing in patients with nummular dermatitis.

BACKGROUND: A chronic dermatosis like nummular dermatitis may be complicated by contact dermatitis due to an impaired cutaneous barrier. This study is aimed at evaluating secondary contact dermatitis in patients with nummular dermatitis. METHODS: Patch testing with the Indian Standard Series was performed in 50 of 78 patients with a clinical diagnosis of nummular eczema. Significant reactions were graded as per ICDRG criteria. RESULTS: Significant reactions were noted in 23 of 50 tested patients. The most frequent sensitizers were colophony, nitrofurazone, neomycin sulfate and nickel sulfate (7.14% each). Reactions to antigens in topical medications, cosmetics and toiletries constituted 64.28% of all the reactions. CONCLUSIONS: Patients with nummular dermatitis are at significant risk of developing secondary allergic contact dermatitis, which contributes to the severity and chronicity of their dermatitis. Patch testing has the potential to improve the quality of life in these patients. Hence, patients with chronic recalcitrant nummular dermatitis must be patch tested.

Adolescent↗
PubMed1992

Epidemic dermatitis due to contact with a moth in Cozumel, Mexico.

In early December 1989, an outbreak that was initially thought to be scabies was investigated among employees of tourist hotels in Cozumel, Mexico. Of 417 employees interviewed, only 19 (4.6%) met a case definition for scabies dermatitis, while 91 (21.8%) reported a nonspecific dermatitis of less than one-week's duration. Persons with nonspecific dermatitis related the onset of their dermatitis to skin contact with a moth that had been present in large numbers in November. At the time of the initial investigation in December, there were no active cases of dermatitis and the moth was no longer present. During early January 1990, numerous cases of dermatitis again began to be reported. Using a case definition for nonspecific dermatitis, a survey of Cozumel's resident population showed an attack rate of 12.1%. A case-control study revealed the only significant risk factor to be skin contact with the suspect moth (P less than 0.01), which had returned in large numbers. Six health workers volunteered to have the moth rubbed on their skin; within 5 min, five of six developed an intense pruritus followed by an erythematous rash. The moth was classified as Hylesia alinda Druce. This species has nettling hairs on its abdomen that excrete a histamine-like substance. Although this moth is normally present in small numbers in Cozumel, the passage of hurricane Gilbert killed most of its natural predators (wasps and bees), allowing its population to overgrow. No control measures were undertaken because the moth's natural predators returned that spring and dramatically reduced the moth population. No further outbreaks of dermatitis occurred.

Adolescent↗
PubMed2001

Telogen effluvium after allergic contact dermatitis of the scalp.

OBJECTIVE: After observing 2 cases of acute telogen effluvium induced by allergic contact dermatitis to hair dyes, we decided to evaluate the effects of acute contact dermatitis of the scalp on the hair cycle. DESIGN: Single-center, 6-month study of consecutive patients affected by acute scalp dermatitis. SETTING: Department of Dermatology, University of Bologna, Bologna, Italy. PATIENTS: Diagnosis of allergic contact dermatitis of the scalp was confirmed by patch testing. Eight women presenting with acute contact dermatitis of the scalp entered the study. Hair shedding was evaluated monthly for 6 months by pull test and wash test. Increased hair loss was detected in 4 of the 7 patients who completed the study. Hair loss was mild to moderate and appeared 2 to 4 months after the episode of scalp dermatitis. A scalp biopsy specimen from 2 patients confirmed the diagnosis of telogen effluvium. CONCLUSIONS: Allergic contact dermatitis of the scalp should be included among the possible causes of telogen effluvium. The pathogenesis of telogen effluvium caused by contact dermatitis is unknown but may be related to cytokine release during the inflammatory process.

Acute Disease↗
PubMed2003

[Analysis of scratching behavior in a picryl chloride induced atopic dermatitis model in mice].

To elucidate the actual state of scratching behavior of NC mice noted when PiCl-induced dermatitis occurs, the circadian rhythm in scratching behavior of this mouse model was examined, and the time when scratching behavior, which is useful to evaluate the severity of itch, occurs was assessed. A steroid drug (Prednisolone ointment), which has been confirmed to inhibit dermatitis from worsening, was used to examine whether or not, or how it inhibits scratching behavior in this mouse model. It became clear that scratching behavior increased during a period from the evening to the night in the animals which had not been sensitized (normal animals); compared with the day time, scratching behavior occurred more often in the nighttime. It also became clear that scratching behavior increased in the animals with PiCl-induced dermatitis increase in the frequency of induction of dermatitis, and Prednisolone ointment significantly inhibited scratching behavior in the animals in which dermatitis had been induced with PiCl six times. From these results, it can be said that scratching behavior increases in PiCl-induced mouse atopic dermatitis models correlatively with the increase in the frequency of induction of dermatitis, and steroid drugs decrease the frequency of the scratching behavior. In conclusion, it is strongly suggested that this mouse model is useful for development of therapeutic methods and novel medicinal drugs for atopic dermatitis.

Animals↗
PubMed2004

[A clinical analysis of 50 cases of medicament-like dermatitis due to trichloroethylene].

OBJECTIVE: To investigate the clinical manifestations, complications and treatment of medicament-like dermatitis due to trichloroethylene (TCE), so as to provide basis for studying its etiology and mechanism. METHODS: Fifty patients with dermatitis due to TCE from 1997 to 2000 were analysed retrospectively. RESULTS: The occurrence of the dermatitis was not parallel to TCE exposure levels, without significant dose-effect relationship. This disease could be caused by both inhalation and skin exposure. The latency period of TCE dermatitis ranged from 5 to 66 days, and the average was 31.5 d (Medium). The major clinical manifestations included skin lesions, fever, superficial lymph node swelling and liver dysfunction. Infection was the major complication. Glucocorticoid was effective for treatment of this disease. CONCLUSION: The clinical manifestations due to TCE exposure were similar to dermatitis medicamentosa. The major clinical types of TCE dermatitis included exfoliative dermatitis and erythema multiforme. The dermatitis is considered to be mediated by delayed-type (IV) hypersensitivity. The key factors to treat this disease successfully included the use of glucocorticoid in time with sufficient dose and full course, professional skin care, active treatment to protect the liver and to avoid infection.

Adolescent↗
PubMed2005

[Do breast-feeding and "diet" milks have any preventive or curative effect in the management of atopic dermatitis in children?].

A) The preventive interest of infants' food in the onset of atopic dermatitis. Measures of prevention of atopic dermatitis concern predisposed children. Most studies agree on the protective effect of breast feeding for at least 3 to 4 months, compared with industrial milk products, on the onset of atopic dermatitis. Partial breast feeding is not protective. There is no preventive effect of breast feeding on the onset of atopic dermatitis in the absence of a family history of atopy. However, a few studies have raised the question of the aggravation of eczema during prolonged breast feeding. The "breast fed" group is probably not a homogenous group. Mothers' milk contains IgA, TGFb-type cytokines and long-chain polyinsaturated fatty acids that may play an important part in the acquisition of tolerance to food and the prevention of atopic dermatitis. The administration of a protein hydrolysate is preferable in terms of prevention of an allergy to a formula based on cow's milk, but does not provide any benefit compared with breast feeding. The preventive effect on atopic dermatitis of a casein hydrolysate is greater than that of a partial hydrolysate, which itself is greater than a formula based on cow's milk. In conclusion, the first preventive measure is breast feeding for 3 to 4 months, associated with intensive protein hydrolysate in the case of mixed feeding. In the absence of breast feeding, intensive hydrolysate is recommended in children at high risk. B) The curative interest of infants' food in the management of atopic dermatitis. The curative interest implies the responsibility of food in the triggering-off or maintenance of atopic dermatitis. This concerns non-diversified infants exhibiting severe or moderate eczema concomitant to digestive disorders. In such cases, the diagnosis of food allergy should be evoked. If the infant is fed on industrial milk, a test diet should be proposed with a hydrolysate or based on amino acids, followed by the re-introduction of the formula used previously. If the infant is exclusively breast fed, diagnosis of an allergy to one of the foodstuffs ingested by the mother should be searched for and treated. Early diagnosis of food allergy in infants, before diversification, is the optimal factor of prognosis.

Breast Feeding↗
PubMed1989

[Dermatitis in slaughtering pigs. A study of the incidence, pathology and its economic significance].

The economic loss resulting from the skinning and trimming of pig carcases is estimated at from 2.5 to 3 million Netherlands guilders per annum. In addition, this dermatitis also gives rise to logistic problems. The pilot project 'Integrated Quality Control' (IQC) is concerned, among other things, with studies designed to result in an optimum method of inspection. For this purpose, the meat inspectors recorded a number of pathological findings on ante-mortem inspection, including 'dermatitis'. Living animals did not show any clinical symptoms, and the dermatitis recorded by the meat inspectors was non-specific. There was believed to be a relationship between scabies (Sarcoptes scabiei var. suis infection) on the farm and the prevalence of dermatitis on the carcases of pigs. To determine whether this dermatitis was due to scabies, pathological and histological investigations were carried out in twenty animals. The recordings of the meat inspector were also analysed. Histopathological findings suggested parasitic infection, also in view of the fact that sarcoptic infection is known to coincide with allergic reactions. Dermatitis was detected in 5,712 out of 722,273 carcases (0.79 per cent) examined in a single plant in 1987; 1,855 cases (1.27 per cent) occurring in the winter, 1,798 cases (0.96 per cent) in the spring, 1,357 cases (0.65 per cent) in the summer and 710 cases (0.39 per cent) in the autumn. With the exception of the winter and spring, the consecutive seasons differed significantly (p less than 0.01). 136,434 animals of sixty-nine pig farms which took part in the IQC programme, were examined in 1987. The prevalence of carcases showing dermatitis on these farms varied from 0 to 6.3 per cent, averaging 0.66 per cent. The pathological findings in these investigations suggest a causal relationship between scabies and 'dermatitis' as recorded by the meat inspector.

Animals↗
PubMed1977

An in vitro study of depressed cell-mediated immunity and of T and B lymphocytes in atopic dermatitis.

Lymphocyte transformation tests, E binding(T) rosette assay and immunofluorescent preparations of B cells were studied in patients with atopic dermatitis, and also in healthy controls. Most of the patients were found to have high levels of IgE in serum. The patients were studied both during severe bouts of dermatitis and also when the dermatitis was almost healed. Lymphocyte transformation tests showed that patients were hyporeactive to PPD and herpes simplex antigen in vitro, both during periods of severe dermatitis and also when the dermatitis was in remission. The response to PHA in the patients was normal in vitro. No factors which could reduce cell-mediated immunity in vitro were found in patients' sera. A decreased number of T lymphocytes and a slight increase in the number of immunoglobulin-bearing lymphocytes (B cells) were demonstrated in the patients, both during remission and during recurrence of severe dermatitis. In 3 of 8 patients, increased numbers of IgE-bearing lymphocytes were found to be present when the patients had severe dermatitis. A possible correlation between high serum levels of IgE and depressed cell-mediated immunity in patients with atopic dermatitis is discussed.

Adult↗
PubMed1995

Differences in lymphocyte proliferative responses to food antigens and specific IgE antibodies to foods with age among food-sensitive patients with atopic dermatitis.

BACKGROUND: Clinical symptoms of patients with food-sensitive atopic dermatitis often improve with increasing age. OBJECTIVE: To investigate this tendency and the underlying mechanism. METHODS: We selected and divided 194 food-sensitive atopic dermatitis patients into three age groups. The proliferative responses of peripheral blood mononuclear cells (PBMCs) to food antigens and specific IgE antibodies to foods then were evaluated with respect to age. We also followed up 55 food-sensitive patients with atopic dermatitis and examined their improvement ratio after 1 year. Further, we investigated changes in lymphocyte proliferative responses to food antigens and specific IgE antibodies to foods in food-sensitive patients with atopic dermatitis during elimination diets. RESULTS: Proliferative responses of PBMCs to ovalbumin of patients in the over 6-years-old group were significantly (P < .05) lower than those of the less than 1-year-old group. Proliferative responses of PBMCs to bovine serum albumin of patients in the over 6-years-old group were significantly (P < .05) lower than those in the 1 to 5-year-old group and in the less than 1-year-old group. RAST values for hen egg in the over 6-years-old group were significantly (P < .05) lower than those for the less than 1-year-old group. Improvement was shown by 13 of the 33 hen egg-sensitive patients with atopic dermatitis, an improvement ratio of 39%, and by 9 of the 22 cow milk-sensitive patients with atopic dermatitis, an improvement ratio of 41%. Proliferative responses of PBMCs to food antigens in food-sensitive patients with atopic dermatitis decreased rapidly after patients were placed on elimination diets. CONCLUSION: The PBMC proliferative responses to food antigens and RAST values were higher for young children and lower for older ones who suffered from food-sensitive atopic dermatitis. Oral tolerance, in addition to the development of digestive and absorptive functions, may be responsible for these immunologic changes.

Adolescent↗
PubMed1995

[Allergic dermatitis caused by metallic implants in orthopedic surgery].

PURPOSE OF THE STUDY: Dermatitis due to metallic implants in orthopaedic surgery are uncommon complications and are difficult to diagnose. MATERIAL AND METHODS: A literature review found descriptions of 54 cases. All types of implants, even small in size such as screws or loops, made of stainless steel or chromium-cobalt alloys have been incriminated. There was no case related to titanium alloy. RESULTS: The clinical aspects were very different; all the forms of dermatitis are possible. The most frequent were eczemas (44 per cent), bullous dermatitis (11 per cent) and inflammatory forms (13 per cent). DISCUSSION: These dermatitis result either from immuno-allergic mechanisms or from cell-toxicity. There are two main diagnostic difficulties. 1--To confirm the responsibility of the implant in the dermatitis because the cutaneous lesions appears often generalized or localized in an area distant from the implant and because their emergence may be very belated, sometime after several years. 2--To distinguish some of these dermatitis and especially inflammatory forms, from sepsis. There is no current means to state positively this diagnosis without removing the implant. The microscopic tissues analysis surrounding the implant and the cutaneous patch-tests using fillings of the implant itself are the only methods which appear able to confirm the diagnosis. There are no reliable means to detect risk subjects, the emergence of a dermatitis seems to be unpredictable. The specificity and the sensibility of the usual patch-tests are insufficient. CONCLUSION: The main means to prevent dermatitis is to reduce the production of metallic particles due to wear, fritting and corrosion. Management is based on removing of the incriminated implant. Treatment using drugs, including local applications or general dispensing of steroids, have generally a low efficiency.

Adolescent↗
PubMedDate not supplied

[From atopic dermatitis to asthma].

The prevalence of atopic dermatitis and other allergic diseases is increasing in industrialized countries. Today we know that atopy is conditioned genetically, but the development of the atopic phenotype requires environmental factors. It is believed that the genetic factors have not changed and that the increased prevalence is due to the increase in exposure to allergenic and non-specific environmental factors. The potential for sensitization is greater in the early years of life, so it is necessary to reduce harmful environmental exposure at these ages. Atopic clinical manifestations develop sequentially, in many cases beginning with atopic dermatitis in the early months of life. We know that children with atopic dermatitis present non-specific bronchial hyperreactivity (58 to 82%), which is a risk factor for the later development of asthma. The presence of specific bronchial hyperreactivity for mites in atopic dermatitis with mite sensitization also has been described, and it has been demonstrated that signs of eczema can develop or become exacerbated by airway exposure during bronchial challenge tests. The evolution from atopic dermatitis to asthma is a possibility that must be kept in mind. Patients should be followed-up and study of hyperreactivity and sensitization to allergens should be carried out in order to prevent the development of clinical symptoms. Prevention should include pneumoallergens, food allergens, and non-specific environmental risk factors, such as parental smoking (particularly mothers), pollution inside and outside the home, etc. Prevention is particularly important in children at risk of allergy, as determined by a family history among first-degree relatives, as well as the presence of atopic dermatitis, particularly of early onset, because these patient are most at risk of developing bronchial asthma in later years. At present, pharmacological prevention is being studied, without overlooking environmental prevention, in children at high risk of atopic disease for the purpose of preventing chronic inflammations that will condition their future as adults. In our daily clinical experience, atopic dermatitis is responsible for 8% of visits to a pediatric allergology unit. We emphasize that 62.5% of our patients with dermatitis are referred when they already have bronchial asthma, which represents an important delay in diagnosis with respect to the onset of symptoms.

Adult↗
PubMed2000

Aetiological factors in vulvar dermatitis.

AIM: To determine aetiological factors in vulvar dermatitis. BACKGROUND: Dermatitis of the vulva is a common clinical diagnosis in the specialized vulva clinic, although the exact prevalence is unknown. Aetiological factors are poorly understood in particular the incidence of atopy and seborrhoeic dermatitis. Other factors implicated are iron deficiency and exogenous causes such as contact irritants and allergens. METHODS: During a 1-year period, 38 patients with an initial clinical diagnosis of vulvar dermatitis were questioned, examined and investigated with full blood count, serum ferritin, bacterial swab where indicated and punch biopsy. After three patients had been excluded with other diagnoses, prick testing and patch testing were carried out. RESULTS: Of the 35 patients with vulvar dermatitis, 34 (97%) had either an atopic background and/or seborrhoeic dermatitis. Iron deficiency occurred in seven patients (20%) and relevant positive patch tests in nine patients (26%). Twenty patients had biopsies and all had confirmatory histology. CONCLUSION: This study suggests that the main aetiological factor in vulvar dermatitis is an endogenous predisposition. Iron deficiency may also contribute, while contact with irritants and allergens may explain the localization and frequently complicates and exacerbates the picture. Secondary sensitization to multiple substances is common.

Adult↗
PubMedDate not supplied

Persistent post-occupational dermatitis.

Wall and Gebauer (Contact Dermatitis 1991: 24: 241-243) first described persistent post-occupational dermatitis (PPOD) as ongoing dermatitis for which there is no obvious present cause, precipitated by prior occupational contact dermatitis (OCD). We propose that individuals exhibiting PPOD lose the capacity for resolution of their condition upon removal from exposure to causative agents and subsequently develop persistent dermatitis, which can be continual or intermittent. Accordingly, we suggest modification of criterion 6 of the OCD criteria developed by Mathias (J Am Acad Dermatol 1989: 20: 842-848): 'Removal from exposure initially leads to improvement of dermatitis, however, over time there may be incomplete or no improvement, despite removal from exposures at work'. To satisfy the definition of PPOD, individuals must meet at least 4 of the 7 criteria, including the altered criterion 6. We present 6 cases of PPOD exemplifying these scenarios, which met the altered Mathias criteria. In some cases, subsequent failure to recognize the initial work relatedness of their skin conditions resulted in the termination of workers' compensation benefits. This situation is particularly relevant in the Australian context. The diagnosis of PPOD needs to be considered in all individuals with work-initiated dermatitis who present with ongoing endogenous-like eczema.

Adult↗
PubMed2003

Atopy, nickel sensitivity, occupation, and clinical patterns in different types of hand dermatitis.

BACKGROUND: The etiologic diagnosis of hand dermatitis (HD) is often difficult. Knowledge of the relationship between atopy and nickel sensitivity as risk factors for HD is limited. OBJECTIVE: To compare irritant contact dermatitis, allergic contact dermatitis, and dyshidrotic eczema relative to personal atopy, patch-testing results, occupation, and clinical patterns. METHODS: From patients referred for patch testing, 714 consecutive individuals with HD were retrospectively studied. RESULTS: Half of the patients had eczema confined to the palms. The dorsal pattern was more prevalent in atopic patients, compared to nonatopic patients. Irritant contact dermatitis was the most frequent diagnosis (55.3%), followed by allergic contact dermatitis (24.4%) and dyshidrotic eczema (20.3%). Among housewives, health workers, and mechanics, irritants were of much greater importance than allergens whereas among hairdressers and bricklayers, the opposite was found. The prevalence of personal atopy did not differ significantly between different types of HD. Nickel sensitivity was much less frequent in irritant contact dermatitis than in allergic contact dermatitis or dyshidrotic eczema. The distribution of clinical patterns was similar. CONCLUSION: This study suggests that different etiologic diagnoses of HD cannot be distinguished by clinical pattern, prevalence of personal atopy, or nickel-sensitivity.

Adult↗