Understanding hand eczema: features, diagnosis and treatment

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.