Clinical Evaluation and Patch Testing in Hand Eczema.

Deepa, M S (2010) Clinical Evaluation and Patch Testing in Hand Eczema. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION : Hand eczema is a descriptive diagnosis for dermatitis largely confined to the hands, and it does not make any presumption about the etiology. 1 It may be endogenous or exogenous (allergic or irritants) in origin. 1 Most of the cases of hand eczema have a multifactorial etiology, 1 wherein the eczema is caused and perpetuated by exogenous factors in individuals who are susceptible to such processes due to endogenous factors. 1,2 Identification and avoidance of the external contactants is of paramount importance in appropriate management of hand eczema. As clinical differentiation between chronic allergic and irritant hand eczemas is often difficult, patch testing becomes an important diagnostic tool for identification of the allergen/allergens responsible for the eczema. 3 Patch testing is a well established method of diagnosing allergic contact dermatitis. Patients with a history and clinical picture compatible with contact dermatitis are reexposed to suspected allergens under controlled conditions to verify the diagnosis. Properly applied and correctly interpreted patch tests are, at present, the only scientific proof of allergic contact dermatitis. This study was conducted to identify the allergens showing positive reactions in patch test in patients with hand eczema. AIM ; 1. To determine the causes of hand eczema among the patients attending out patient department of Dermatology during the period of August 2007- September 2009. 2. To report occupations frequently associated with hand dermatitis. 3. To indicate which substances were the more common allergens among individuals evaluated by patch testing for hand dermatitis. 4. To determine the predominant age group affected by hand eczema. 5. To estimate the underlying atopy association in patients with hand eczema 6. To determine the common site of involvement. 7. To document the various morphological types of hand eczema. CONCLUSION : We encountered a high degree of patch test positivity in patients with hand eczema and the Indian standard series proved to be very useful, but lacking in certain cases like hand eczema in housewives. Housewives formed the bulk of our study group and a high degree of sensitivity to vegetables has been established in the past. Inclusion of the extracts of common vegetables and fruits in the series would be of immense value. Since more than half of hand dermatitis cases may be related to occupation, a thorough history should be taken by a knowledgeable clinician. Potentially relevant allergens in the workplace must be identified and tested. These allergens may not be contained in standard trays. A specific patch test series for the hands as in footwear series or textile series will be an aid in diagnosis of hand eczema.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Clinical Evaluation ; Patch Testing ; Hand Eczema.
Subjects: MEDICAL > Dermatology Venereology and Leprosy
Depositing User: Subramani R
Date Deposited: 05 Jul 2017 04:31
Last Modified: 05 Jul 2017 09:01

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