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PubMed2002

The association between contact allergy and hand eczema in 2 cross-sectional surveys 8 years apart.

Hand eczema is a recurrent chronic skin disease related to contact allergy and atopic dermatitis. When possible, efforts should be redoubled to eliminate provoking factors. Our objective was to assess changes in the prevalence of self-reported hand eczema and to evaluate the association between contact allergy and hand eczema among adult Danes before and after nickel exposure regulation in Denmark. In 1990 and 1998, random samples of 15-41-year-old persons were examined in 2 cross-sectional studies of the general population in Copenhagen, Denmark. The studies included questionnaires, patch and prick testing. From 1990 to 1998 the prevalence of a history of hand eczema increased significantly. This increase did not appear to be fully explained by changes in the prevalence of flexural eczema, prick test reactivity, patch test reactivity, and nickel allergy. In 1990, nickel allergy and allergic nickel contact dermatitis were significantly associated with a history of hand eczema among women. In 1998, these associations were not found. It can be concluded that, from 1990 to 1998, the prevalence of a history of hand eczema rose significantly. It was indicated that it might be possible to prevent the hand eczema related to nickel allergy by exposure regulation, public education or both.

Adolescent↗
PubMed2002

Eczema: quality of life by body site and the effect of patch testing.

BACKGROUND: Patients with dermatitis are known to have impaired quality of life. Whether this varies according to body site has not been evaluated. Patch tests have previously been shown to influence quality of life, although no previous studies have shown if this is dependent on the results of the patch tests. OBJECTIVES: To evaluate the impact of patch testing on quality of life according to the outcome of the investigations and to determine how quality of life varies according to eczema body site. METHODS: One hundred and sixty consecutive adult patients with active eczema were selected from a patch test clinic for inclusion into the study. Quality of life was determined using the Dermatology Life Quality Index (DLQI) and the SF-36, prior to patch testing and 2 months later. Perceived eczema severity at each time point was also noted, along with the outcome of patch testing. Baseline comparison of quality of life was performed between four body site groups (face, hand, generalized, other). RESULTS: Patients confirmed as having relevant positive contact allergens were shown to have a significant improvement in both perceived eczema severity (P = 0.0004) and DLQI score (P = 0.0015) at 2 months after patch testing. No significant changes were noted in the SF-36 score, other than a borderline improvement in the pain score (P = 0.048). The improvement in quality of life and eczema severity was not noted in patients with negative patch tests. Eighty-nine per cent of patients diagnosed as having contact allergy were able to comply with avoidance advice. No significant variation was noted in quality of life according to body site affected by eczema. There was a positive correlation between DLQI score and perceived eczema severity (P < 0.0001). CONCLUSIONS: Patients confirmed as having contact allergy show a subsequent improvement in eczema severity and an improvement in quality of life.

Adolescent↗
PubMed1990

Predictive factors for hand eczema.

Factors related to hand eczema were studied. Their relative importance as predictors was ranked by multiple logistic regression analysis. Questionnaires were sent to 20,000 individuals aged 20-65 years, randomly selected from the population register. Those subjects (1385) considering themselves to have had hand eczema within the previous 12 months were invited to a dermatological examination. It was found that a history of childhood eczema was the most important predictive factor for hand eczema. Second was female sex, followed by occupational exposure, a history of asthma and/or hay fever, and a service occupation. A small decrease in risk with advancing age was also found. The difference in the probability of having had eczema in a 1-year period, between individuals having the most important risk factors studied and those having none of them, proved to be for females 48% compared to 8%, and for males 34% compared to 4%. A history of childhood eczema was found to be more common among young persons, indicating an increase in the prevalence of atopic dermatitis. Of those individuals who reported childhood eczema, 27% reported hand eczema on some occasion during the last 12 months.

Adult↗
PubMed2006

Nickel allergy and hand eczema--a 20-year follow up.

The aim of this study was to investigate the occurrence of hand eczema after 20 years in women patch tested to nickel during childhood. In 1982-1983, 960 schoolgirls were patch tested for nickel allergy; its prevalence was found to be 9%. 20 years later, the same individuals received a questionnaire regarding hand eczema and factors of importance for the development of hand eczema. 735 of 908 women (80.9%) answered the questionnaire. In total, 17.6% of respondents reported hand eczema after the age of 15 years, and the 1-year prevalence was 12.8%. There was no statistically significant difference in the occurrence of hand eczema between the groups who had previously tested positive and negative for nickel allergy. 38.3% of the respondents considered themselves to be nickel sensitive at the time they answered the questionnaire; in this group, the reported prevalence of hand eczema after age 15 was 22.5%. 31.4% of those with a history of atopic dermatitis reported hand eczema after age 15, compared with 10.6% of those without (P < 0.001). In conclusion, contact allergy to nickel in childhood did not seem to increase the prevalence of hand eczema later in life.

Adult↗
PubMed2005

Significant improvement of eczema with skin care and food elimination in small children.

AIM: To evaluate common methods of investigation and treatment in children younger than 2 y of age with eczema, with or without sensitization to food allergens. METHODS: One hundred and twenty-three children younger than 2 y of age with eczema and suspected food allergy were included in this prospective study. The children underwent skin-prick test with cow's milk, fresh hen's egg white and wheat. Specific IgE to milk and egg white was analysed. The eczema extent and severity was estimated with SCORAD before and after treatment. Children with a positive skin-prick test were instructed to exclude that food item from their diet. All children were treated with emollients and topical steroids when needed. RESULTS: Sixty-two of the children were skin-prick positive to at least one of the allergens; 62% had mild, 30% moderate and 8% severe eczema at their first visit. After treatment, 90% had mild, 10% moderate and 0% severe eczema. Forty-six per cent of the children had circulating IgE antibodies to milk or egg white. Ten per cent had specific IgE but negative skin-prick test to the same allergen. This subgroup improved their eczema significantly without elimination diet. CONCLUSION: The conventional treatments for children with eczema, i.e. skin care and food elimination, are effective. The beneficial effect of skin care as the first step should not be neglected, and it may not be necessary to eliminate food allergens to relieve skin symptoms in all food-sensitized children with eczema.

Antibodies, Anti-Idiotypic↗
PubMed2004

Association of parental eczema, hayfever, and asthma with atopic dermatitis in infancy: birth cohort study.

OBJECTIVE: To evaluate the association of parental history of atopic disease with childhood atopic dermatitis, and to examine the relative strength of associations with maternal and paternal disease. DESIGN: Mothers were recruited to the Avon longitudinal study of parents and children (ALSPAC) from the eighth week of pregnancy. Before parturition, both parents were asked, separately, to report their lifetime history of eczema, asthma, and hayfever. Parents reported symptoms of atopic dermatitis in their children at ages 6, 18, 30, and 42 months. RESULTS: Of 8530 children with complete information on rash at ages 6, 18, 30, and 42 months, 7969 had complete information on maternal atopic disease and 5658 on maternal and paternal atopic disease. There was a strong association between parental eczema and childhood atopic dermatitis: odds ratio 1.69 (95% confidence interval, 1.47 to 1.95) for maternal eczema only, 1.74 (1.44 to 2.09) for paternal eczema only, and 2.72 (2.09 to 3.53) for eczema in both parents. Associations with parental asthma or hayfever were attenuated after controlling for parental eczema. There was no evidence that associations with maternal atopy were stronger than with paternal. CONCLUSIONS: Associations between parents' atopic disease and the risk of atopic dermatitis in offspring vary according to the type of atopic disease in the parents, but not according to parental sex. These results are at variance with previous studies reporting stronger associations with maternal than paternal atopy, and suggest that there is no "parent-of-origin" effect in atopic dermatitis. Parental eczema may be a better marker than parental asthma/hayfever in predisposing to childhood eczema.

Adult↗
PubMed1994

Childhood eczema: disease of the advantaged?

OBJECTIVE: To determine whether the increased prevalence of childhood eczema in advantaged socioeconomic groups is due to increased parental reporting. DESIGN: Comparison of parental reports of eczema with visible eczema recorded by medical officers during a detailed physical examination. SETTING: National birth cohort study. SUBJECTS: 8279 children from England, Wales, and Scotland born during 3-9 March 1958 and followed up at the ages of 7, 11, and 16. MAIN OUTCOME MEASURES: Prevalence of eczema according to parental report compared with medical officer's examination at the ages of 7, 11, and 16. RESULTS: Prevalence of both reported and examined eczema increased with rising social class at the ages of 7, 11, and 16 years. The point prevalence of examined eczema at age 7 was 4.8%, 3.6%, 3.6%, 2.4%, 2.2%, and 2.4% in social classes I, II, III non-manual, III manual, IV, and V respectively (chi 2 value for linear trend 12.6, P < 0.001). This trend persisted after adjustment for potential confounders such as region and family size and was not present for examined psoriasis or acne. CONCLUSIONS: Eczema is more prevalent among British schoolchildren in social classes I and II than those in lower classes. Exposures associated with social class are probably at least as important as genetic factors in the expression of childhood eczema.

Adolescent↗
PubMed1998

Occurrence of self reported hand eczema in Swedish bakers.

OBJECTIVES: To estimate the risk of bakers developing hand eczema. The importance of atopy was studied as well as change of job due to hand eczema. METHODS: A retrospective cohort study was performed among bakers trained in Swedish trade schools in 1961-89 (n = 2923). School referents followed other programmes (n = 1258); population controls were randomly selected from the general population (n = 1258). A questionnaire on self reported hand eczema, year of onset of hand eczema, change of work due to hand eczema, childhood eczema, family atopy, and work history was posted to all participants. RESULTS: The incidence of hand eczema among male controls was 4.4-5.4 cases/1,000 person-years compared with 16.7 for bakery work. The corresponding figures for women were 11.3-14.1 compared with 34.4. The relative risk for male bakers was 3.5 (95% confidence interval (95% CI) 2.8 to 4.5) and for female bakers 2.8 (2.2 to 3.6). Skin atopy increased the incidence about threefold and a synergistic effect of atopy and exposure was indicated. Also, bakers had changed job significantly more often than controls. CONCLUSIONS: Swedish bakers, mainly working during the 1970s and 1980s, have about a threefold increased risk of hand eczema. There seems to be a synergistic effect of atopy and occupational exposure.

Adult↗
PubMed2001

Montelukast and improvement of eczema: observations from a prescription event monitoring study in England.

OBJECTIVE: Montelukast is an orally administered cysteinyl receptor antagonist, approved for the treatment of asthma. There is pharmacological plausibility of its effectiveness in the treatment of other immunologically mediated conditions such as eczema and urticaria. The objective of this study was to determine whether there are any beneficial effects of montelukast on eczema and urticaria. METHOD: A non-interventional observational cohort study was conducted between February 1998 and December 1998 using Prescription-Event Monitoring (PEM). During PEM studies, patients are systematically identified from dispensed prescription data and questionnaires are sent to the prescribing general practitioner (GP) asking them to report events occurring during and after treatment. In this study, events reported as eczema or urticaria improved were identified. A simple questionnaire was sent to the GPs for additional information. RESULTS: The cohort comprised 15,612 patients, in which 16 reports of eczema or urticaria improved were identified. Questionnaires were sent to the GPs for additional information. Fifteen of the 16 questionnaires were returned. In 5 cases the GPs thought that there was an improvement of eczema or urticaria with montelukast treatment in patients who had history of longstanding eczema or urticaria. Of the remaining 11 cases there was an alternative explanation for the improvement of eczema or urticaria in 10 cases and one was unassessable. CONCLUSION: PEM is conducted to monitor the safety of medicines, and doctors report events including improvement in pre-existing conditions. Although the number of cases of improvement of eczema or urticaria in this cohort is small, there is a possibility that leukotriene inhibitors may be helpful in the treatment of these diseases. Further studies are needed to provide evidence as to whether montelukast will have a role in the treatment of these conditions.

Acetates↗
PubMed2003

Treatment of hand eczema.

Hand eczema is a common skin disease that tends to become chronic and may interfere with many types of work. Emollients have been shown to be useful in reducing eczema activity and in the primary prevention of hand eczema. Protection of the hands is very important for the prevention of hand eczema and is a fundamental aspect of the treatment of hand eczema. Although topical corticosteroids are the mainstay of treatment, few studies of their rational use, efficacy and side-effects have been conducted. A combination of tacrolimus and topical corticosteroids may reduce the risk of steroid-associated side-effects. Systemic treatment with immunosuppressants such as cyclosporine and methotrexate show promising results, and acitretin may suppress keratotic hand eczema. Botulinum toxin has been used with success in the treatment of dyshidrotic hand eczema. PUVA is effective as a systemic treatment. Bath-PUVA treatment, UVB and Grenz rays can also suppress hand eczema.

Eczema↗
PubMed1994

The prevalence of childhood atopic eczema in a general population.

BACKGROUND: Atopic eczema has become more common during recent decades, but few studies have looked at its prevalence in the general community. OBJECTIVE: Our purpose was to ascertain the prevalence of atopic eczema, its age of onset, and its relationship to breast-feeding and ear piercing in a general practice population. METHODS: Children (N = 1104), aged 3 to 11 years, were identified from a computerized register in a socially and ethnically mixed English general practice population of 13,314. Of these, 1077 children (97.6% recruitment) were interviewed with parents or guardians, and the resultant data were recorded on a survey form. RESULTS: The lifetime occurrence of atopic eczema was 20% in boys (12% in the past year) and 19% in girls (11% in the past year). Prevalence in the past year was 10% to 14% in boys aged 3 to 11 years but fell in girls from 15% at 3 to 5 years to 8% at 9 to 11 years. Atopic eczema developed in the first 12 months of life in 60% of the children who had the condition, and it developed in the first 6 months of life in three quarters of these children. Ear piercing had been performed in 35% of girls and 3% of boys and was most prevalent in social classes 3, 4, and 5. More than half the girls aged 9 to 11 years had pierced ears. Breast-feeding did not affect the prevalence of atopic eczema. CONCLUSION: The lifetime prevalence of atopic eczema was 20% in children aged 3 to 11 years. There was no evidence that ear piercing perpetuated eczema in this age group. Breast-feeding did not protect against the development of atopic eczema.

Asthma↗
PubMed1998

The natural history of childhood eczema: observations from the British 1958 birth cohort study.

The National Child Development Study (NCDS) is a birth cohort study whose longitudinal design makes it suitable for examining the natural history of common diseases in childhood such as atopic eczema. We have analysed the age of onset and clearance rates for examined and/or reported eczema in 6877 children born during the period 3-9 March 1958 for whom linked data were available at birth and at the ages of 7, 11, 16 and 23 years. Of the 870 cases with examined or reported eczema by the age of 16 years, 66% had age of onset by the age of 7 years. Of the 571 children with reported or examined eczema by the age of 7 years, the proportion of children who were clear in terms of examined eczema or reported eczema in the last year at ages 11 and 16 years was 65% and 74%, respectively. These 'apparent' or short-term clearance rates fell to 53% and 65%, respectively, after allowance for subsequent recurrences in adolescence and early adulthood. Age of onset of community-ascertained cases of atopic eczema may be later than that reported in hospital-based studies. The long-term prognosis of childhood eczema may be worse than some previous studies have suggested, especially when subsequent recurrences are taken into account.

Adolescent↗
PubMed2001

Environmental associations with eczema in early life.

BACKGROUND: Although atopic eczema (AE) is a common disease, little is known about its causes. OBJECTIVES: To investigate the role of dietary and environmental factors associated with the development of AE by the age of 2 years. METHODS: A cohort of children was recruited before birth from a consecutive series of newly pregnant mothers presenting for antenatal care at three general practices in Ashford, Kent, U.K. Data up to the age of 2 years were available for 624 (97%) of the original cohort. AE was defined using components of the U.K. diagnostic criteria for AE, maternal report of doctor-diagnosed eczema and maternally reported eczema. Exposures of interest were family history of allergic disease, dietary and breastfeeding patterns, family size and exposure to indoor domestic allergens. RESULTS: The cumulative prevalence of AE using the U.K. diagnostic criteria was 14% (95% confidence interval, CI 11-17%). The prevalence of maternally reported doctor-diagnosed eczema was much higher (31%, 95% CI 27-35%) and almost half (45%) the mothers reported that their child had ever had eczema (95% CI 41-49%). The relationship between parental atopy, parental history of allergic disease and the child's eczema was consistently stronger for the mothers than the fathers. There was a marked increase in the prevalence of eczema with increasing maternal education and in less crowded homes, associations that remained significant after controlling for other factors. CONCLUSIONS: The associations with environmental factors are consistent with the hypothesis that more crowded houses, increased family size and birth order, which may possibly increase early exposure to infections, may offer protection from subsequent development of eczema.

Adult↗
PubMed2002

Breastfeeding duration is a risk factor for atopic eczema.

BACKGROUND: The results of numerous studies on the influence of breastfeeding in the prevention of atopic disorders are often contradictory. One of the most important problems is confounding by other lifestyle factors. OBJECTIVE: The aim of the present study was to analyse the effect of any breastfeeding duration on the prevalence of atopic eczema in the first seven years of life taking into account other risk factors. METHODS: In an observational birth cohort study 1314 infants born in 1990 were followed-up for seven years. At 3, 6, 12, 18, 24 months and every year thereafter, parents were interviewed and filled in questionnaires, children were examined and blood was taken for in vitro allergy tests. Generalized Estimation Equations (GEE)-models were used to model risk factors for the prevalence of atopic eczema and for confounder adjustment RESULTS: Breastfeeding was carried out for longer if at least one parent had eczema, the mother was older, did not smoke in pregnancy, and the family had a high social status. The prevalence of atopic eczema in the first seven years increased with each year of age (OR 1.05; 95% CI 1.01-1.09 for each year), with each additional month of breastfeeding (1.03; 1.00-1.06 for each additional month), with a history of parental atopic eczema (2.06; 1.38-3.08), and if other atopic signs and symptoms appeared, especially specific sensitization (1.53; 1.25-1.88), and asthma (1.41; 1.07-1.85). Although breastfeeding should be recommended for all infants, it does not prevent eczema in children with a genetic risk. CONCLUSION: Parental eczema is the major risk factor for eczema. But in this study, each month of breastfeeding also increased the risk.

Age Distribution↗
PubMed1992

A prospective study of the development of hand eczema in an automobile manufacturing industry.

We have not been able to find any prospective study of the risk of developing occupational dermatitis in the car manufacturing industry. To try to define individual predictive risk factors for the development of hand eczema and to determine the prevalence of hand eczema within 1 year in an automobile manufacturing industry, we investigated prospectively 1564 new employees during one year of employment. Only persons with previous atopic dermatitis or hand eczema were restricted to dry and clean workplaces. The employees were personally interviewed and examined before their employment. Written questionnaires were used at 3 and 12 months to obtain information on type of work, exposure, protection and hand dermatitis. All patients developing hand eczema were examined, patch tested and followed to determine the course and consequence of their eczema. The risk turned out to be only 4% on average, but significantly higher in females (6%). Certain sections within the factory such as wet work (canteen/kitchen and cleaning) and work in the paint shop with high exposure to organic solvents carried significantly higher risks. Heavy exposure to mineral oil, a known risk factor, was effectively counteracted by the extensive use of protective gloves to yield a lower than average prevalence in the press and body shop. Individual risk factors for the development of hand eczema were previous hand eczema, atopic dermatitis, but also wool intolerance and hay fever as isolated phenomena. Most cases of hand eczema were mild, of irritant contact type and only 1 employee developed an allergic contact dermatitis due to the working environment.(ABSTRACT TRUNCATED AT 250 WORDS)

Automobiles↗
PubMed2003

[Prevalence of symptoms of asthma, allergic rhinitis, conjunctivitis and atopic eczema: ISAAC (International Study of Asthma and Allergies in Childhood) in a population of schoolchildren in Zagreb].

OBJECTIVE: Numerous studies of the population prevalence of asthma, allergic rhinitis, and atopic eczema revealed some international differences. However, the International Study of Asthma and Allergies in Childhood (ISAAC) was the first one using a standardized methodology to evaluate the prevalence of these diseases, and to make comparisons within and between countries. The results showed marked variations in 12-month prevalence of asthma, allergic rhinoconjunctivitis, and atopic eczema symptoms with 20-fold (range 1.6-36.8%), 30-fold (range 1.4-39.7%), and 60-fold (range 0.3-20.5%) differences between the centres with the highest and the lowest prevalence, respectively. AIM: Our aim was to gain the insight into the prevalence of allergic diseases in Zagreb, Croatia by the methods of internationally standardized protocol, proposed by the ISAAC Steering Committee. METHODS: Original questionnaires, translated from English into Croatian, consisting of questions about the child's demographic characteristics, core modules on wheezing, rhinitis and eczema, and supplementary modules, were completed by parents of 10-year-old children (4th grade) attending 18 elementary schools in a city of Zagreb. Total of 1047 questionnaires were returned and analysed after the inconsistent responses were eliminated by phone calling. DISCUSSION: Phase one of the ISAAC study has shown a wide variation in the prevalence of asthma, allergic rhinoconjunctivitis, and atopic eczema symptoms throughout the world, with differing international patterns for the different disorders. Four prevalence ranges have been established for better illustration of the geographic distribution of asthma prevalence: (I) < 5%; (II) 5 to < 10%; (III) 10 to < 20%; (IV) > or = 20%. The highest 12-month prevalences of asthma symptoms were found in developed countries (UK, Australia, New Zealand, Republic of Ireland, and most centres in North, Central, and South America), being in prevalence range IV. The lowest prevalences (range I) were found in several Eastern European countries, Indonesia, Greece, China, Taiwan, Uzbekistan, India, and Ethiopia. According to the results of our study, a continental part of Croatia with a 12-month prevalence of wheezing of 6.02% corresponds to range II. Prevalence of asthma symptoms was greater in males, which is consistent with the results of the younger age group previously analysed. For allergic rhinoconjunctivitis and atopic eczema symptoms grouping of centres with a high prevalences into specific regions was less well defined than for asthma. Centres with the highest prevalences were scattered across the world. In contrast, centres with the lowest prevalences were similar to those for asthma symptoms. Our results of the 12-month prevalence of allergic rhinoconjunctivitis (12.13%), and atopic eczema (7.83%) symptoms were somewhere between the two extremes. As with asthma symptoms, the prevalence of rhinoconjunctivitis symptoms was greater in males. Contrary, the difference in prevalence of atopic eczema symptoms between the sex groups has not been found. The worldwide variations in prevalence of asthma, allergic rhinoconjunctivitis, and atopic eczema symptoms suggest that environmental factors may be critical to the development of these disorders in childhood. Furthermore, different patterns of geographical distribution of particular disorders suggest that major risk factors for them may be different or may involve different latency periods and time trends. Therefore, studies that include objective clinical assessment are required. CONCLUSION: According to our results, Zagreb is a city with relatively low prevalence of allergic diseases symptoms. Larger sample size of at least 3000 subjects is required to provide sufficient precision for estimates of symptom severity, and to generate adequate number of subjects with particular disorders for further analyses. Therefore, we recently increased our sample size to more than 3000 subjects, and started ISAAC Phase two (clinical examination, measures of bronchial hyperresponsiveness, measures of atopy, measures of environmental exposure to aeroallergens, and genetic analyses) in Zagreb, Croatia.

Asthma↗
PubMed2006

Prevalence of atopic eczema and related symptoms in Brazilian schoolchildren: results from the International Study of Asthma and Allergies in Childhood (ISAAC) phase 3.

BACKGROUND: International comparisons of the prevalence of atopic eczema and related symptoms are scarce. The standardized protocol of the International Study of Asthma and Allergies in Childhood (ISAAC) facilitates investigation of prevalence all over the world. OBJECTIVE: To apply the ISAAC written questionnaire to evaluate the prevalence of atopic eczema and related symptoms among 6-7 year-old children and 13-14 year-old adolescents living in 20 Brazilian cities. METHODS: The ISAAC written questionnaire was filled in by 23,422 children aged 6-7 years and 58,144 adolescents aged 13-14 years living in 2 population centers in the north, 8 in the northeast, 1 in the midwest, 5 in the southeast, and 5 in the south. RESULTS: The prevalence of flexural eczema (itchy rash ever in characteristic places in the last 12 months) ranged from 5.3% to 13.0% for children and was lower among the adolescents (range, 3.4%-7.9%). Among children, the highest rates were observed in population centers in the northeast, mainly along the coast. Among adolescents the highest rates were observed in the north and northeast, mainly in Natal, Aracaju, and Vitória da Conquista. The northeastern countryside had higher prevalence rates of severe eczema (kept awake at night by this itchy rash in the last 12 months) in comparison to northeastern coastal centers. There was a significant correlation between the prevalence of flexural eczema and severe eczema for both age groups, separately (6-7 year-olds, prho= 0.756, P<.004; 13-14 year-olds, rho=0.874, P<.0001) or grouped (6-7 plus 13-14 years-olds, rho=0.696, P<.0001). CONCLUSION: The prevalence of eczema and related symptoms is variable in Brazil, where the highest prevalence is found in the north and northeast; on the other hand, a higher prevalence of severe eczema was observed in Brazilian centers in the south.

Adolescent↗
PubMed1985

[Prospective study of the importance of constitutional parameters in the development of eczema in hairdressers and construction workers].

The considerable rate of professional hand eczema in hairdressers, especially in young ones, emphasizes the necessity of practicable methods for early diagnosis of risk and manifestation of eczema. Therefore, we investigated different constitutional parameters of the skin (hyperhidrosis, dyshidrosis and acrocyanosis of the hands, seborrhea, sebostasis, white dermographism) in a prospective study of 210 hairdressers' and 95 bricklayers' apprentices over 3 years. In addition, the alkali resistance and the permeability of the horny layers (by nitrazine yellow) were examined every year in each of the probands. Among other results dyshidrosis and sebostasis proved to be statistically relevant in the development of hand eczema, whereas no statistic causality was seen for acrocyanosis and hyperhidrosis. Risk of eczema could not be diagnosed early by alcali resistance tests. Frequent wet-work and insufficient skin protection were further factors causing eczema, especially in atopic subjects. There was also a statistically relevant correlation between a periumbilical eczema (caused by metallic buttons on jeans), indicating allergy against nickel, and pierced earlobes. The results of this prospective study show that by simple clinical methods serious risks of eczema in hairdressers and bricklayers can be detected already in the first years of work. Several practical recommendations for prevention of occupational eczema in hairdressers are given.

Adolescent↗