Patel Viki, Atwater Amber Reck, Reeder Margo
Mr. Patel and Dr. Reeder are from the University of Wisconsin School of Medicine and Public Health, Madison. Dr. Reeder is from the Department of Dermatology. Dr. Atwater is from the Department of Dermatology, Duke University School of Medicine, Durham, North Carolina.
Cutis. 2021 Mar;107(3):129-132. doi: 10.12788/cutis.0204.
Hand contact dermatitis is common, and irritant contact dermatitis (ICD) is more likely than allergic contact dermatitis (ACD) in both occupational and nonoccupational settings. Irritant contact dermatitis can have acute and chronic presentations, and hand hygiene products can contribute. The most common relevant hand contact allergens in North American patch test populations are methylisothiazolinone (MI), nickel, formaldehyde, quaternium-15, and fragrance mix I. In health care workers, rubber accelerators often are relevant as potential contact allergens. Clinically, it can be difficult to differentiate between ICD and ACD, and patch testing often is required for definitive diagnosis. When patch testing is indicated, supplemental allergen series in addition to a screening series often are needed. Management of hand contact dermatitis requires gentle skin care, avoidance of irritants and/ or allergens when appropriate, and prescription topical or systemic therapies or phototherapy when indicated.
手部接触性皮炎很常见，在职业和非职业环境中，刺激性接触性皮炎（ICD）比过敏性接触性皮炎（ACD）更易发生。刺激性接触性皮炎可表现为急性和慢性，手部卫生用品可能是其诱因。北美斑贴试验人群中最常见的相关手部接触变应原是甲基异噻唑啉酮（MI）、镍、甲醛、季铵盐-15和香料混合物I。在医护人员中，橡胶促进剂常作为潜在的接触变应原。临床上，区分ICD和ACD可能很困难，通常需要进行斑贴试验以明确诊断。当需要进行斑贴试验时，除了筛查系列外，通常还需要补充变应原系列。手部接触性皮炎的治疗需要温和的皮肤护理，适当避免刺激物和/或变应原，以及在必要时使用处方局部或全身治疗或光疗。
