Hand Eczema. Part 1: epidemiology, pathogenesis, diagnosis and work-up.

Hand eczema (HE), also referred to as hand dermatitis, is a frequent medical condition that can have an important negative impact on quality of life. Occupational HE is an important cause of medical disability. Multiple inflammatory pathways are upregulated, and barrier genes are downregulated in HE. Atopic dermatitis and wet work are two important risk factors for HE. Clinical presentation can be variable and location of may comprise palmar and dorsal aspects, fingers, fingertips and wrists of one or both hands. Work-up is directed at identifying causative factors and excluding other diagnoses. The first article of this CME series focuses on epidemiology, etiopathogenesis, differential diagnosis, work-up and patch testing.