Allergens associated with severe symptoms of hand eczema and a poor prognosis

作者：Hald Marianne^*; Agner Tove; Blands Jette; Ravn Henrik; Johansen Jean Duus

来源：Contact Dermatitis, 2009, 61(2): 101-108.

DOI：10.1111/j.1600-0536.2009.01577.x

• allergens
• follow-up
• hand eczema
• HECSI
• patch test
• prognosis

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.

• 出版日期2009