Kang Yun Chul, Lee Sanghoon, Ahn Sung Ku, Choi Eung Ho
Department of Dermatology, Yonsei University Wonju College of Medicine, Korea.
J Dermatol. 2002 Aug;29(8):477-83. doi: 10.1111/j.1346-8138.2002.tb00312.x.
Hand eczema is a common skin disease. Because of its variable etiologies and clinical manifestations, it is difficult to determine the etiology from the clinical manifestation. Among the contact allergens, nickel is the most common. Patients with hand eczema and a nickel allergy have a poorer prognosis than patients without a nickel allergy. The reason is still uncertain; suggestions include persistent exposure to nickel or a weak skin barrier. The purpose of our study was to identify the characteristic clinical manifestations by etiology and to compare the skin barrier state between patients with nickel allergies and those without them. Ninety-three patients were classified into 4 types; irritation contact type, allergic contact type, atopic type and mixed type. After the sodium lauryl sulfate (SLS) test to compare the skin barrier state, visual score and transepidermal water loss (TEWL) were measured and analyzed statistically. From this study, it was not possible to ascertain a statistical difference, however a few characteristic clinical manifestations according to etiology can be stated. There was no difference in the visual scoring system or the TEWL after the SLS irritation test between the nickel-allergy group and the non-allergy group. Therefore, we believe that the poor prognosis of hand eczema with nickel allergy may be due to the nickel allergy itself rather than skin barrier state.
手部湿疹是一种常见的皮肤病。由于其病因和临床表现各异，很难从临床表现来确定病因。在接触性变应原中，镍最为常见。手部湿疹伴镍过敏的患者比无镍过敏的患者预后更差。原因尚不确定，推测包括持续接触镍或皮肤屏障功能薄弱。我们研究的目的是按病因确定特征性临床表现，并比较镍过敏患者和无镍过敏患者的皮肤屏障状态。93例患者被分为4型：刺激性接触型、变应性接触型、特应型和混合型。在进行月桂醇硫酸酯钠（SLS）试验以比较皮肤屏障状态后，测量视觉评分和经表皮水分流失（TEWL）并进行统计学分析。从本研究中，无法确定统计学差异，不过可以阐述一些根据病因的特征性临床表现。镍过敏组和非过敏组在SLS刺激试验后的视觉评分系统或TEWL方面没有差异。因此，我们认为手部湿疹伴镍过敏预后较差可能是由于镍过敏本身而非皮肤屏障状态。
