Giwercman Charlotte, Lerbaek Anne, Bisgaard Hans, Menné Torkil
Department of Dermatology, Copenhagen University Hospital Gentofte, DK-2900 Hellerup, Denmark.
Contact Dermatitis. 2008 Nov;59(5):257-60. doi: 10.1111/j.1600-0536.2008.01426.x.
Hand eczema is a common disease with various risk factors of which atopic dermatitis is known to be one of the most important. Recently, two mutations in the gene coding for filaggrin, a protein important for the skin barrier, have repeatedly been shown to be associated with atopic dermatitis. Moreover, one study point towards an association between the filaggrin null alleles and the subgroup of patients having both hand eczema and atopic dermatitis. For the remainder of hand eczema patients, still unknown genetic risk factors exist. We propose that in future, classification of atopic hand eczema should distinguish between patients with and without the filaggrin null alleles and to further differentiate between associations with type I allergy, type IV allergy and exposure to irritants, respectively. Furthermore, we suggest future studies of atopic hand eczema to analyse for the filaggrin mutations. We believe this will increase the possibility of subgrouping this otherwise heterogenic disease and thereby enable a better phenotype-genotype characterization of hand eczema. This could improve the preventive initiatives, secure better information of patients about the prognosis for their disease, and possibly enable targeted treatment.
手部湿疹是一种常见疾病，有多种风险因素，其中特应性皮炎是最重要的因素之一。最近，编码中间丝相关蛋白的基因发生的两种突变（中间丝相关蛋白是一种对皮肤屏障很重要的蛋白质）已多次被证明与特应性皮炎有关。此外，一项研究表明中间丝相关蛋白无效等位基因与同时患有手部湿疹和特应性皮炎的患者亚组之间存在关联。对于其余手部湿疹患者，仍存在未知的遗传风险因素。我们建议，未来特应性手部湿疹的分类应区分携带和不携带中间丝相关蛋白无效等位基因的患者，并进一步分别区分与I型过敏、IV型过敏和接触刺激物之间的关联。此外，我们建议未来针对特应性手部湿疹的研究分析中间丝相关蛋白的突变情况。我们相信，这将增加对这种原本异质性疾病进行亚组分类的可能性，从而能够更好地对手部湿疹进行表型-基因型特征描述。这可以改进预防措施，为患者提供更好的疾病预后信息，并可能实现针对性治疗。
