Search

Background: Hand eczema is a disease with large variation in clinical presentation and severity. Scoring systems for quantitative severity assessment exist. However, they are observer‐dependent. An objective quantitative tool for scoring of hand eczema would improve categorization of hand eczema. Objective: To investigate the usefulness of multispectral imaging in assessing severity of hand eczema with respect to extent and the different morphological features. Methods: Patients with hand eczema (n = 60) and healthy controls (n = 28) were included. The severity of hand eczema was assessed by a dermatologist using the Hand Eczema Severity Index (HECSI) and a global assessment (Physician Global Assessment [PGA]). Multispectral imaging of the hand was performed on all patients and controls using the VideometerLab Instrument. Results: Areas of the morphological elements identified by multispectral imaging were statistically significantly correlated with the PGA scores. Analyzed by Cohen's kappa, a moderate agreement between imaging‐based severity assessment and PGA was found. The imaging‐based severity assessment was also correlated with HECSI (Spearman rho 0.683, P < .001). Still, the imaging‐based algorithm was not capable of differentiating hand eczema patients from controls. Conclusions: Multispectral imaging allows quantitative measurements of different skin parameters to be performed. In its present form, multispectral imaging cannot replace the clinical assessment of a dermatologist. However, after refinement, this or similar technologies could prove useful. [ABSTRACT FROM AUTHOR]

According to the material safety data sheet (MSDS) the product consisted of an acrylic polymer-based powder with declared polymethylmethacrylate and a monomer-based liquid with methyl methacrylate (MMA) and ethylene glycol dimethacrylate (EGDMA). 2 Koutis D, Freeman S. Allergic contact stomatitis caused by acrylic monomer in a denture. [Extracted from the article]

Internationally approved guidelines for the diagnosis and management of Malassezia-related skin diseases are lacking. Therefore, a panel of experts consisting of dermatologists and a microbiologist under the auspices of the Danish Society of Dermatology undertook a data review and compiled guidelines for the diagnostic procedures and management of pityriasis versicolor, seborrhoeic dermatitis and Malassezia folliculitis. Main recommendations in most cases of pityriasis versicolor and seborrhoeic dermatitis include topical treatment which has been shown to be sufficient. As first choice, treatment should be based on topical antifungal medication. A short course of topical corticosteroid or topical calcineurin inhibitors has an anti-inflammatory effect in seborrhoeic dermatitis. Systemic antifungal therapy may be indicated for widespread lesions or lesions refractory to topical treatment. Maintenance therapy is often necessary to prevent relapses. In the treatment of Malassezia folliculitis systemic antifungal treatment is probably more effective than topical treatment but a combination may be favourable. [ABSTRACT FROM AUTHOR]

No generally accepted classification scheme for hand eczema exists. The Danish Contact Dermatitis Group recently developed a guideline defining common clinical types and providing criteria for aetiological types. To test the concepts of this guideline in a group of hand eczema patients. Seven hundred and ten hand eczema patients were included from seven dermatology clinics in Denmark. The hand eczema was classified into one of five clinical types, with standard photographs as reference. The severity was scored by the physician, who also made a final aetiological diagnosis. Irritant contact dermatitis was most frequent in chronic, dry fissured hand eczema (44.3%), pulpitis (41.7%), and nummular hand eczema (40.9%), whereas allergic contact dermatitis dominated in vesicular types of hand eczema, with recurrent (35%) and few (24.2%) eruptions. Hyperkeratotic palmar hand eczema was the only clinical type that constituted a distinct subgroup; it was found most frequently in older men and had the strongest relationship, although not significant, with non-specific dermatitis. The relationship between clinical type of hand eczema and aetiological diagnosis fitted with general experience, but no simple relationship was found. This emphasizes that patch testing and exposure analysis are mandatory. Hyperkeratotic palmar hand eczema was identified as a distinct clinical subtype. [ABSTRACT FROM AUTHOR]

Background: Contact allergy is frequent among persons with hand eczema and may be associated with a poor prognosis. Objectives: To identify allergens associated with the most severe initial clinical symptoms and the worst prognosis in a cohort of hand eczema patients followed for 6 months. Methods: The study population comprised 799 consecutive hand eczema patients enrolled during January 2006–February 2007. All patients were patch tested with the European baseline series. Severity assessment of the hand eczema was performed initially and at the 6-month follow-up using a validated scoring system (HECSI). With logistic regression analyses, associations of severe hand eczema or a poor prognosis with 15 individual allergens were analysed and adjusted for by sex, age, atopic dermatitis and other allergens. Results: At baseline, greater severity of hand eczema was associated with a positive patch test to formaldehyde, methyldibromo glutaronitrile, sesquiterpene lactone mix, nickel sulfate and potassium dichromate. A poor prognosis was associated with chromate allergy, odds ratio: 4.18 (95% CI: 1.42–12.28). Conclusions: Nickel, chromate, formaldehyde, methyldibromo glutaronitrile and sesquiterpene lactone mix were allergens associated with the greatest severity of hand eczema. Patients with chromate allergy had the worst prognosis. [ABSTRACT FROM AUTHOR]

The use of nickel in certain consumer goods has been regulated in Denmark since 1990. The aim of this study was to reveal the clinical characteristics of nickel-allergic patients seen in seven private dermatology clinics and to identify current sources of nickel that may elicit nickel dermatitis. During 2006 to 2007, 634 patients with dermatitis aged 17-91 years were patch-tested and completed a questionnaire including a question about the occurrence of dermatitis following skin contact with ear-rings or ear-pins, watches, buttons or metal clasps (i.e. metal dermatitis). χ² tests were applied to test for statistical significant differences. Analysis revealed a lower prevalence of nickel allergy among women in the youngest age group (17-22 years) in comparison with older age groups (23-34 years and 35-46 years) (p<0.03). Most patients experienced metal dermatitis on the first occurrence between 1975 and 1985. No new cases of metal dermatitis were identified after 1985. We conclude that nickel allergy has decreased among young females with dermatitis due to the nickel regulation. [ABSTRACT FROM AUTHOR]

Background The severity of hand eczema is of interest in epidemiological studies. Ideally, as no validated methods of self-assessment exist, a dermatologist should examine all subjects. However, this is very resource intensive. Objectives To examine if severity grading performed by patients with hand eczema using a self-administered photographic guide was in agreement with the assessment performed by a trained dermatologist. Furthermore, to measure the correlation between the severity of hand eczema expressed on a visual analogue scale (VAS) and the clinical severity assessment, using the photographic guide. Methods Fifty-three consecutive outpatients with hand eczema were included, a number based on a prestudy statistical calculation. The patients were asked to grade current severity of their hand eczema by choosing one of four groups of photographs representing differing severities of hand eczema. On the same day all patients were examined by an experienced dermatologist, who graded the severity using the same photographic guide. The photographic guide was a modified version of a validated guide for use by physicians. In addition, the patients rated the severity of their hand eczema on a VAS. Results Fifty-one of the respondents completed the full questionnaire. For 37 of the 51 patients (73%) the clinical severity assessments of patient and dermatologist were identical. The measure of agreement, Cohen's kappa coefficient, was 0.61, indicating good inter-rater agreement. The correlation between the dermatologist-rated severity and the corresponding score by the patients on the VAS was only moderate (Spearman's rank correlation coefficient rho = 0.52). Conclusions The photographic guide for the self-assessment of hand eczema is an easy instrument to use, and for research purposes can be a reliable tool for patients with hand eczema to grade severity. A VAS can only be considered as a mediocre tool for estimation of the dermatologist-rated clinical severity, but should be validated as an independent instrument to assess severity of hand eczema. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 24-year-old woman who is suffering from atopic dermatitis that is presented with chronic hand eczema. It details the results of the patient's patch testing which revealed an allergic reaction to sorbitan sesquioleate that was found on the vinyl rubber gloves that the patient wore when doing tasks that involves prolonged contact with water. It offers information on sorbitan sesquioleate which is considered as a weak allergen.

The article discusses a study on potential factors related to low quality of life in patients with hand eczema. It highlights materials and methods used including a self-administered photographic guide, skin patch test, and the Dermatology Life Quality Index (DLQI) questionnaires. It reports that hand eczema shows a measurable impact on the quality of life of the patients.

The article presents a case study of a 27-year-old woman who suffered from allergic contact eczema on three different occasions on using nose pads, flip-flops with rubber straps, and watch with rubber straps. A patch testing was performed with high-performance liquid chromatography (HPLC), which concluded that the eczema was caused by drometrizole in all three cases.

The article describes the case of a 62-year-old male patient with a history of keratonic follicular papules, erythematous annular scaly plaques and tinea corporis and who developed Darrier disease (DD) due to cutaneous terbinafine-resistant Tricophyton rubrum infection. The diagnosis was confirmed after performing skin scraping, direct microscopy, Sabouraud agar culture and antifungal susceptibility testing. A discussion on drug resistance in dermatophytes is presented.

The article presents a case study of a 22-year-old non-atopic man who developed hand eczema after three months of working in a plumbing equipment supplier. The man had allergies to black rubber chemicals in terms of cross-sensitization to p-Phenylenediamine (PPD) which he got from his previous temporary henna tattoo. The article discusses that occupational hand eczema can be caused by black rubber products in terms of allergic sensitization to PPD resulting from a temporary henna tattoo.

The article presents a case study of a 68-year old non-atopic man who was referred from Department of Urology due to suspected allergic skin reaction. It states that the patient had been diagnosed with prostate cancer, and 2 days later developed severe swelling and redness of scrotal and penile skin. It notes that patch testing was performed using extended European baseline series. It mentions that he was informed about contact allergy to cetrimide.

Background: Rosacea is a common chronic inflammatory facial skin disorder. Standardized evaluation of the severity and extent of rosacea is important for baseline assessment and treatment effect. The currently used Investigator's Global Assessment (IGA) is unspecific and fails to consider subtypes/phenotypes of rosacea and area involvement. The Rosacea Area and Severity Index (RASI) was developed to give a more nuanced evaluation of rosacea features in four facial skin areas adjusted to the relative importance of each area of the face to obtain an overall severity score. Objectives: To validate RASI against the IGA and to assess the inter‐ and intraobserver reliability for RASI. Methods: Sixteen dermatologists evaluated photographs of 60 adult patients with rosacea (3 photographs per patient, one from the front and one from each side). IGA and RASI scores were performed for interobserver reliability assessment. To determine intraobserver reliability, 14 dermatologists evaluated 10 other patients twice with at least 1 week interval. Results: The IGA and RASI correlated well (Spearman correlation coefficient (SCC) = 0.75, 95% confidence interval (CI) = 0.72–0.78). Interobserver reliability was moderate for RASI and poor to moderate for IGA. Reliability was strongest for rhinophyma, followed by papules/pustules and erythema, and rather weak for telangiectasia. For area scores, interobserver reliability was strongest for cheeks, followed by nose, chin and forehead. We found a moderate‐to‐strong intraobserver agreement both for IGA and RASI. Conclusions: We have designed a new practical tool to examine clinical severity of rosacea. RASI proved simple and reliable in scoring clinical severity of rosacea with an agreement comparable to the currently used IGA although RASI will provide a more nuanced view of the current rosacea extent and severity. We suggest that RASI is used in the daily clinical setting as well as in clinical studies assessing the efficacy of rosacea therapies. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 68-year-old non-atopic woman was presented with recurrent perioral and lip dermatitis and oedema of the oral mucosa following dental treatments. It mention that she had been using protective rubber gloves and experienced fluctuating hand eczema with erythema and vesicles on the dorsal aspects of the hands.

The article focuses on the study related to occupational hand eczema caused by nickel allergy and semi-quantified from dimethylglyoxime testing of the skin. It mentions that nickel is an important cause of occupational allergic contact dermatitis. It states that excessive nickel exposure is shown in many occupations.

A case study of 21-year-old non-atopic woman with face eczema was referred for allergy testing, is presented. It mentions patient's facial contact dermatitis caused by methylchloroisothiazolinone/methylisothiazolinone in a stainless steel aerosol spray. It also mentions the need of legal intervention in allergic contact dermatitis caused by MCI/MI in an occupational setting.