Ortiz-Salvador José María, Subiabre-Ferrer Daniela, García Rabasco Ana, Esteve-Martínez Altea, Zaragoza-Ninet Violeta, Alegre de Miquel Víctor
Servicio de Dermatología, Hospital General Universitario de Valencia, Valencia, España.
Servicio de Dermatología, Hospital General Universitario de Valencia, Valencia, España.
An Pediatr (Engl Ed). 2018 Jun;88(6):309-314. doi: 10.1016/j.anpedi.2017.07.005. Epub 2017 Aug 31.
Hand eczema is a frequent disease in adults. Diagnosing the cause of hand eczema is difficult due to different classifications. There is lack of evidence on hand eczema and its causes in children.
A total of 389 children between 0 and 16 years were identified between 1996 and 2016, from whom 42 (10.8%) with exclusively hand eczema were selected. In all cases a standard battery of epicutaneous patch tests was performed, as well as additional batteries depending on the clinical suspicion. The clinical and epidemiological features of these children were recorded and compared against children with eczema in other locations.
The 42 children with hand eczema included 25 (60.5%) girls, and 17 (40.5%) boys, with a mean age of 10.6 +- 3.9 years, and did not differ from that of children with eczema in other locations. The definitive diagnosis after patch-testing was Atopic Dermatitis in 15 cases, Allergic Contact Dermatitis in 14 patients, Endogenous Vesiculous Eczema in 6 cases, Endogenous Hyperkeratotic Eczema in 5 cases, and Irritant Contact Dermatitis in 2 cases. The most frequent allergens detected were thiomersal (9 cases), nickel (5 cases), mercury (5 cases), and cobalt (4 cases).
Hand eczema is a common condition in children. The most common cause is atopic dermatitis, although cases of allergic contact dermatitis manifesting as hand eczema are not uncommon. Any child with eczema of hands in whom an allergic cause is suspected should be referred for patch- testing.
手部湿疹是成人中的常见疾病。由于分类不同，诊断手部湿疹的病因较为困难。目前缺乏关于儿童手部湿疹及其病因的证据。
在1996年至2016年间共识别出389名0至16岁的儿童，从中选取了42名（10.8%）仅患有手部湿疹的儿童。所有病例均进行了标准系列的皮肤斑贴试验，并根据临床怀疑进行了额外的系列试验。记录了这些儿童的临床和流行病学特征，并与其他部位患有湿疹的儿童进行了比较。
42名患有手部湿疹的儿童中，女孩25名（60.5%），男孩17名（40.5%），平均年龄为10.6±3.9岁，与其他部位患有湿疹的儿童无差异。斑贴试验后的确诊结果为：15例为特应性皮炎，14例为过敏性接触性皮炎，6例为内源性水疱性湿疹，5例为内源性角化过度性湿疹，2例为刺激性接触性皮炎。检测到的最常见过敏原为硫柳汞（9例）、镍（5例）、汞（5例）和钴（4例）。
手部湿疹在儿童中较为常见。最常见的病因是特应性皮炎，尽管表现为手部湿疹的过敏性接触性皮炎病例也并不少见。任何怀疑有过敏性病因的手部湿疹患儿都应转诊进行斑贴试验。
