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Difficulties: Evaluating patients with atopic dermatitis or atopic hand eczema is a unique challenge for the occupational dermatologist. It is not only necessary to distinguish atopic dermatitis or atopic hand eczema from other forms of eczema and arrive at a appropriate diagnosis but in many instances it is also difficult to determine causation because the role of exogenous as well as endogenous factors needs to be established by the expert. Only when this process is completed can a recommendation concerning the liability of the insurer be made. Assessment of disease continuing after termination of occupational exposure: It can be difficult to determine the causation if the eczema that was primarily caused by occupational exposure does not fade away after the activity responsible for the initial damage has been terminated. As there is no commonly accepted algorithm to decide if the skin lesion is still caused by the former contact to the responsible agents on the job or if endogenous factors are responsible for the skin disease after the occupational exposure has been terminated, every case must be meticulously judged by taking into consideration the conflicting individual factors. [ABSTRACT FROM AUTHOR]