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Understanding hand eczema: features, diagnosis and treatment

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Hand eczema can affect both the backs and palms of the hand, causing painful itches and burns

The words ‘eczema’ and ‘dermatitis’ are used synonymously to describe a polymorphic pattern of cutaneous inflammation.1

Hand eczema is a common condition seen in primary care, occurring at any age with a 1-year median prevalence in the general population of 9.7% (11.4% among women and 5.4% among men)2 and is particularly prevalent in people with a history of atopic eczema.3 Occupational exposure includes, but is not confined to, cleaning, catering, metalwork, hairdressing, healthcare, housework, painting and mechanical work and frequent hand washing often leads to symptoms.3,4 There may not be one single cause for hand eczema. It is often multifactorial, with genetic (constitutional); injury (irritant contact dermatitis), immune reactions (allergic contact dermatitis) and unknown factors playing a part.3 These will provide the focus for this paper.

Clinical Features

Hand eczema can affect the dorsal (backs of the hands) or the palmar (palms) aspects of the hands. Both and can be very itchy, often burning, and can be painful. Clinically, the presentation will vary and be dependent on the cause with acute, relapsing and chronic phases.3,6


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