Contact dermatitis of the hands: Cross-sectional analyses of North American Contact Dermatitis Group Data, 1994-2004

doi:10.1016/j.jaad.2007.04.016

Journal of the American Academy of Dermatology

Volume 57, Issue 2, August 2007, Pages 301-314

https://doi.org/10.1016/j.jaad.2007.04.016 Get rights and content

Background

Hand dermatitis, including irritant and allergic contact dermatitis (ACD), is common.

Objective

To evaluate allergens, relevant irritants, sources and occupations associated with hand contact dermatitis using North American Contact Dermatitis Group (NACDG) data.

Methods

A cross-sectional analysis of 22,025 patients patch tested between 1994 and 2004.

Results

Hand involvement was found in 6953 patients; 959 had ACD as the only diagnosis. In these 959 patients, the 12 most frequent relevant allergens were quaternium-15 (16.5%), formaldehyde (13.0%), nickel sulfate (12.2%), fragrance mix (11.3%), thiuram mix (10.2%), balsam of Peru (9.6%), carba mix (7.8%), neomycin sulfate (7.7%), bacitracin (7.4%), methyldibromoglutaronitrile/phenoxyethanol 2.0% (7.4%), cobalt chloride (6.5%), and methyldibromoglutaronitrile/phenoxyethanol 2.5% (6.3%). Rubber allergens were most commonly associated with occupation. One third of patients with hand ACD had identifiable relevant irritants.

Limitations

Cross-sectional analyses prevent evaluation of causal associations.

Conclusion

In NACDG patients with hand ACD, the most common allergens included preservatives, metals, fragrances, topical antibiotics, and rubber additives.

Section snippets

NACDG database

Between July 1, 1994 and December 31, 2004, 22,025 patients referred for allergen testing were patch tested to the NACDG standard series of 50 to 65 allergens, as previously described.32, 33 Data were collected in subgroups: 07/01/1994–06/30/1996, 07/01/1996–06/30/1998, 07/01/1998–12/31/2000, 01/01/2001–12/31/2002, and 01/01/2003–12/31/2004. Data collected included demographics (age, gender, and race), site of dermatitis, occupation, irritants, and allergens (relevancy and relation to

Demographics

Table I shows the total number of patients, the number of patients with any hand involvement (group A), and the number of patients with only hand involvement (group B) by data time-period and for the NACDG dataset as a whole. Demographics, presented in Table II, were examined in all patients in the NACDG dataset and separately in patients with ACD of the hand (groups C and D).

Diagnosis codes for exclusive hand involvement

The prevalence rates of the 12 final diagnostic codes collected are presented in Table III for patients with the hand as

Discussion

Comparison of our results with previously published studies is challenging because of different criteria used for both inclusion and relevance. Nonetheless, our analyses document several key findings. First, 31.6% (6953/22,025) of patch-tested patients had hand involvement. This proportion likely underestimates the prevalence of hand dermatitis, as patients with multiple sites of dermatitis may have been coded as “scattered generalized” rather than “hand.” Second, not surprisingly, 49.9% (1723

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Study funding sources: None. Grant support: National Institutes of Health T32 GM08244-15 (to R. L. A.).

Conflicts of interest: None declared.

Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.

Reprints not available from the authors.

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ReportContact dermatitis of the hands: Cross-sectional analyses of North American Contact Dermatitis Group Data, 1994-2004

Background

Objective

Methods

Results

Limitations

Conclusion

Section snippets

NACDG database

Demographics

Diagnosis codes for exclusive hand involvement

Discussion

J Am Acad Dermatol

J Invest Dermatol

Am J Contact Dermatol

Am J Contact Dermatitis

J Am Acad Dermatol

J Am Acad Dermatol

J Am Acad Dermatol

Am J Contact Dermatitis

Hand eczema and other hand dermatoses in South Sweden (thesis)

Acta Derm Venereol Suppl (Stockh)

Nickel allergy and hand dermatitis in a stratified sample of the Danish female population: an epidemiologic study including a statistic appendix

Acta Derm Venereol

Hand dermatoses in Tromsö

Contact Dermatitis

Prevalence of eczema and other dermatoses of the hands and arms in the Netherlands. Association with age and occupation

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Occupational dermatoses in Singapore

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Incidence of work-related hand eczema during apprenticeship: first results of a prospective cohort study in the car industry

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Knowledge of skin hazards and the use of gloves by Australian hairdressing students and practicing hairdressers

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Risk factors influencing the development of hand eczema in a population-based twin sample

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Fifteen-year follow-up of hand eczema: persistence and consequences

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Prognosis of hand eczema—a follow-up study

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Leading work-related disease and injuries—dermatologic conditions

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An epidemiological comparison between occupational and non-occupational hand eczema

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Patch testing with preservatives at St. John's from 1982 to 1993

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Report
Contact dermatitis of the hands: Cross-sectional analyses of North American Contact Dermatitis Group Data, 1994-2004