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Work-Related and Occupational Hand Eczema (OHE), Diagnosis and Treatment

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Handbook of Occupational Dermatoses

Part of the book series: Updates in Clinical Dermatology ((UCD))

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Abstract

The definition of occupational hand eczema (OHE) varies from country to country as it additionally includes specific national legal requirements that define when and how work-related hand eczema (HE) should be recognized as an occupational disease. OHE has often a chronic and relapsing course with a poor prognosis in the long-term leading to a significant burden in terms of sick leave, reduced work productivity, early work retirement, and unemployment. Irritant contact dermatitis (ICD), allergic contact dermatitis (ACD), and contact urticaria (CU) account for approximately one-third of all occupational-related medical complaints and 90%–95% of occupation-related skin complaints. It is interesting that in most of the patients one or more additional diagnoses were given. This reflects the fact that, in most cases, HE is a multifactorial disease, and this becomes even more prominent in severe and long-lasting cases. Nowadays, healthcare workers in COVID-19 care units developed HE more frequently associated with increased hand hygiene practices than no-COVID-19 patient care units (48.3% vs 12.7%). Work-related and OHE are highly preventable by elimination, substitution, or reduction of occupational skin exposure to irritants and allergens (primary prevention). Treatment should consider removing causative agents, an anti-inflammatory therapy and finally recover the skin barrier.

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References

  1. Alfonso JH, Bauer A, Bensefa-Colas L, et al. Minimum standards on prevention, diagnosis and treatment of occupational and work-related skin diseases in Europe - position paper of the COST Action StanDerm (TD 1206). J Eur Acad Dermatol Venereol. 2017;31(4):31–43.

    Article  CAS  PubMed  Google Scholar 

  2. Lachapelle JM. Clinical subtypes and categorization of hand eczema: an overview. In: Alikhan A, Lachapelle JM, Maibach H, editors. Textbook of hand eczema. Berlin: Springer-Verlag, Berlin; 2014. p. 25–36.

    Chapter  Google Scholar 

  3. Thyssen JP, Johansen JD, Linneberg A, Menné T. The epidemiology of hand eczema in the general population--prevalence and main findings. Contact Dermatitis. 2010;62:75–87.

    Article  PubMed  Google Scholar 

  4. Anveden Berglind I, Alderling M, Järvholm B, et al. Occupational skin exposure to water: a population-based study. Br J Dermatol. 2009;160(3):616–21.

    Article  CAS  PubMed  Google Scholar 

  5. Meding B, Järvholm B. Incidence of hand eczema—a population-based retrospective study. J Invest Dermatol. 2004;122(4):873–7.

    Article  CAS  PubMed  Google Scholar 

  6. Meding B, Lindahl G, Alderling M, et al. Is skin exposure to water mainly occupational or nonoccupational? A population-based study. Br J Dermatol. 2013;168(6):1281–6.

    Article  CAS  PubMed  Google Scholar 

  7. Mollerup A, Veien NK, Johansen JD. An analysis of gender differences in patients with hand eczema - everyday exposures, severity, and consequences. Contact Dermatitis. 2014;71(1):21–30.

    Article  PubMed  Google Scholar 

  8. Vindenes HK, Svanes C, Lygre S, et al. Prevalence of, and work-related risk factors for, hand eczema in a Norwegian general population (The HUNT Study). Contact Dermat. 2017;77:214–23.

    Article  Google Scholar 

  9. Augustin M. Pharmacoeconomics of occupational diseases. In: Kanerva’s occupational dermatology. T. Rustemeyer T (ed), Elsner P (ed), John SM (ed), Maibach H (ed). 2nd edn springer-Verlag. Ther Ber. 2012;2:19–25.

    Google Scholar 

  10. Cvetkovski RS, Zachariae R, Jensen H, et al. Prognosis of occupational hand eczema: a follow-up study. Arch Dermatol. 2006;142:305–11.

    Article  PubMed  Google Scholar 

  11. Lerbaek A, Kyvik KO, Mortensen J, et al. Heritability of hand eczema is not explained by comorbidity with atopic dermatitis. J Invest Dermatol. 2007a;127(7):1632–40.

    Article  CAS  PubMed  Google Scholar 

  12. Lerbaek A, Kyvik KO, Ravn H, et al. Incidence of hand eczema in a population-based twin cohort: genetic and environmental risk factors. Br J Dermatol. 2007b;157(3):552–7.

    Article  CAS  PubMed  Google Scholar 

  13. Meding B, Wrangsjö K, Järvholm B. Fifteen-year follow-up of hand eczema: predictive factors. J Invest Dermatol. 2005;124(5):893–7.

    Article  CAS  PubMed  Google Scholar 

  14. Yngveson M, Svensson A, Johannisson A, Isacsson A. Hand dermatosis in upper secondary school pupils: 2-year comparison and follow-up. Br J Dermatol. 2000;142(3):485–9.

    Article  CAS  PubMed  Google Scholar 

  15. Meding B, Wrangsjö K, Järvholm B. Hand eczema extent and morphology--association and influence on long-term prognosis. J Invest Dermatol. 2007;127(9):2147–51.

    Article  CAS  PubMed  Google Scholar 

  16. Heede NG, Thyssen JP, Thuesen BH, et al. Anatomical patterns of dermatitis in adult filaggrin mutation carriers. J Am Acad Dermatol. 2015;72(3):440–8.

    Article  CAS  PubMed  Google Scholar 

  17. Heede NG, Thyssen JP, Thuesen BH, et al. Predictive factors of self-reported hand eczema in adult Danes: a population-based cohort study with 5-year follow-up. Br J Dermatol. 2016;175(2):287–95.

    Article  CAS  PubMed  Google Scholar 

  18. Lagrelius M, Wahlgren C-F, Bradley M, et al. Filaggrin gene mutations in relation to contact allergy and hand eczema in adolescence. Contact Dermatitis. 2020;82(3):147–52.

    Article  CAS  PubMed  Google Scholar 

  19. Reich A, Wilke A, Gediga G, et al. Health education decreases incidence of hand eczema in metal work apprentices: results of a controlled intervention study. Contact Dermatitis. 2020;82(6):350–60.

    Article  PubMed  Google Scholar 

  20. Kezic S, Visser MJ, Verberk MM. Individual susceptibility to occupational contact dermatitis. Ind Health. 2009;47:469–78.

    Article  CAS  PubMed  Google Scholar 

  21. Timmerman J, Heederik D, Spee T, et al. Contact dermatitis in the construction industry: the role of loss-of-function mutations. Br J Dermatol. 2016;174:348–55.

    Article  CAS  PubMed  Google Scholar 

  22. Visser MJ, Landeck L, Campbell LE, McLean WH, Weidinger S, Calkoen F, et al. Impact of atopic dermatitis and loss-of-function mutations in the gene on the development of occupational irritant contact dermatitis. Br J Dermatol. 2013;168:326–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Visser MJ, Verberk MM, Campbell LE, McLean WH, Calkoen F, Bakker JG, et al. Filaggrin loss-of-function mutations and atopic dermatitis as risk factors for hand eczema in apprentice nurses: part II of a prospective cohort study. Contact Dermatitis. 2014;70:139–50.

    Article  PubMed  Google Scholar 

  24. Bandier J, Ross-Hansen K, Carlsen BC, et al. Carriers of filaggrin gene (FLG) mutations avoid professional exposure to irritants in adulthood. Contact Dermatitis. 2013;69(6):355–62.

    Article  CAS  PubMed  Google Scholar 

  25. Meisser SS, Altunbulakli C, Bandier Jet al (2020) Skin barrier damage after exposure to paraphenylenediamine. J Allergy Clin Immunol 145(2):619–631

    Google Scholar 

  26. Carøe TK, Ebbehøj N, Agner T. A survey of exposures related to recognized occupational contact dermatitis in Denmark in 2010. Contact Dermatitis. 2014;70(1):56–62.

    Article  PubMed  Google Scholar 

  27. Lund T, Petersen SB, Flachs EM, et al. Risk of work-related hand eczema in relation to wet work exposure. Scand J Work Environ Health. 2020;46(4):437–45.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Rycroft RJ, Smith WD. Low humidity occupational dermatoses. Contact Dermatitis. 1980;6(7):488–92.

    Article  CAS  PubMed  Google Scholar 

  29. Brans R, Skudlik C, Weisshaar E, et al. Association between tobacco smoking and prognosis of occupational hand eczema: a prospective cohort study. Br J Dermatol. 2014;171(5):1108–15.

    Article  CAS  PubMed  Google Scholar 

  30. Olesen CM, Agner T, Ebbehøj NE, Carøe TK. Factors influencing prognosis for occupational hand eczema: new trends. Br J Dermatol. 2019a;181(6):1280–6.

    Article  CAS  PubMed  Google Scholar 

  31. Olesen CM, Agner T, Ebbehøj NE, Carøe TK. Factors influencing prognosis for occupational hand eczema: new trends. Br J Dermatol. 2019b;181(6):1280–6.

    Article  CAS  PubMed  Google Scholar 

  32. Thyssen JP, Schuttelaar LA, Alfonso JH, et al. Guidelines for diagnosis, prevention and treatment of hand eczema. Contact Dermatitis. 2021;86:357. https://doi.org/10.1111/cod.14035.

    Article  Google Scholar 

  33. Diepgen TL, Andersen KE, Chosidow O, et al. Guidelines for diagnosis, prevention and treatment of hand eczema. J Dtsch Dermatol Ges. 2015;13(1):1–22.

    Article  Google Scholar 

  34. Kersh AE, Johansen M, Ojeaga A, de la Feld S. Hand dermatitis in the time of COVID-19: a review of occupational irritant contact dermatitis. Dermatitis. 2021;32(2):86–93.

    Article  CAS  PubMed  Google Scholar 

  35. Johansen JD, Hald M, Andersen BL, et al. Danish contact dermatitis group. Classification of hand eczema: clinical and aetiological types. Based on the guideline of the Danish Contact Dermatitis Group. Contact Dermatitis. 2011;65(1):13–21.

    Article  PubMed  Google Scholar 

  36. Veien NK. Acute and recurrent vesicular hand dermatitis. Dermatol Clin. 2009;27(3):337–53.

    Article  CAS  PubMed  Google Scholar 

  37. Agner T, Elsner P. J Eur Acad Dermatol Venereol. 2020;34(1):4–12.

    Article  PubMed  Google Scholar 

  38. Friis UF, Menné T, Flyvholm MA, et al. Occupational allergic contact dermatitis diagnosed by a systematic stepwise exposure assessment of allergens in the work environment. Contact Dermatitis. 2013;69(3):153–63.

    Article  CAS  PubMed  Google Scholar 

  39. Hersle K, Mobacken H. Hyperkeratotic dermatitis of the palms. Br J Dermatol. 1982;107(2):195–201.

    Article  CAS  PubMed  Google Scholar 

  40. Wollenberg A, Feichtner K. Atopic dermatitis and skin allergies - update and outlook. Allergy. 2013;68(12):1509–19.

    Article  CAS  PubMed  Google Scholar 

  41. García Pérez A, Conde-Salazar Gómez L, Giménez Camarasa J. In: Tratado de dermatosis profesionales. Giménez Camarasa J (ed). 1st edn Eudema Universidad. Madrid. 1987;5:517–28.

    Google Scholar 

  42. Lampel HP, Powell HB. Occupational and hand dermatitis: a practical approach. Clin Rev Allergy Immunol. 2019;56(1):60–71.

    Article  PubMed  Google Scholar 

  43. Gonzalez de Domingo MA, Conde-Salazar Gómez L. Tratamiento de las dermatosis laborales. In: Conde-Salazar Gómez L, editor. Dermatología Profesional, vol. 35. 1st ed. Madrid: Aula Médica; 2003. p. 491–500.

    Google Scholar 

  44. Maghfour J, Maibach H. Are topical corticosteroids effective for chronic irritant contact dermatitis? Dermatitis. 2021;32(6):148–50.

    Article  Google Scholar 

  45. Jing M, Yu Q, Zhu B, et al. Topical 0.05% clobetasol cream in the treatment of chronic hand eczema. A protocol for systematic review and meta-analysis. Medicine. 2021;100(10):e24418.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Bauer A, Lange N, Matterne U, et al. Efficacy of pimecrolimus 1% cream in the long-term management of atopic hand dermatitis. A double-blind RCT. J Dtsch Dermatol Ges. 2012;10:426–33.

    PubMed  Google Scholar 

  47. Diepgen TL, Elsner P, Schliemann S, et al. Guideline on the management of hand eczema ICD-10 code: L20. L23. L24. L25. L30. J Dtsch Dermatol Ges. 2009;7(3):1–16.

    Google Scholar 

  48. Juntongjin P, Chunhakham P. Synergistic effects of the 308-nm excimer light and topical Calcipotriol for the treatment of chronic hand eczema: a randomized controlled study. Dermatology. 2021;237(1):31–8.

    Article  CAS  PubMed  Google Scholar 

  49. Ruzicka T, Lynde CW, Jemec GB, et al. Efficacy and safety of oral alitretinoin (9-cis retinoic acid) in patients with severe chronic hand eczema refractory to topical corticosteroids: results of a randomized, double-blind, placebo-controlled, multicentre trial. Br J Dermatol. 2008;158:808–17.

    Article  CAS  PubMed  Google Scholar 

  50. Menne T, Johansen JD, Sommerlund M, Veien NK. Hand eczema guidelines based on the Danish guidelines for the diagnosis and treatment of hand eczema. Contact Dermatitis. 2011;65(1):3–12.

    Article  PubMed  Google Scholar 

  51. Williams C, Wilkinson SM, McShane P, Lewis J, et al. A double-blind, randomized study to assess the effectiveness of different moisturizers in reventing dermatitis induced by hand washing to simulate healthcare use. Br J Dermatol. 2010;162(5):1088–92.

    Article  CAS  PubMed  Google Scholar 

  52. Lodén M. Effect of moisturizers on epidermal barrier function. Clin Dermatol. 2012;30(3):286–96.

    Article  PubMed  Google Scholar 

  53. Loman L, Diercks G, Schuttelaar M. Three cases of non-atopic hyperkeratotic hand eczema treated with dupilumab. Contact Dermatitis. 2021;84(2):124–7.

    Article  CAS  PubMed  Google Scholar 

  54. Abdali S, Yu J. Occupational dermatoses related to personal protective equipment used during the COVID-19 pandemic. Dermatol Clin. 2021;39:555–68.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Erdem Y, Inal S, Sivaz O, et al. How does working in pandemic units affect the risk of occupational hand eczema in healthcare workers during the coronavirus disease-2019 (COVID-19) pandemic: a comparative analysis with nonpandemic units. Contact Dermatitis. 2021;1:1–10.

    Google Scholar 

  56. Araghi F, Tabary M, Gheisari M, et al. Hand hygiene among health care WorkersDuring COVID-19 pandemic: challenges and recommendations. Dermatitis. 2020;31(4):223–37.

    Article  Google Scholar 

  57. Lan J, Song Z, Miao X, Li H, et al. Skin damage among healthcare workers managing coronavirus disease-2019. J Am Acad Dermatol. 2020;82(5):1215–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Dermatology Unit at Hospital Vithas 9 de Octubre, Valencia, Spain

    Juan Pedro Russo

  2. Framingham Medical Center, La Plata, Buenos Aires, Argentina

    Juan Pedro Russo

  3. Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway

    José Hernán Alfonso

  4. Department of Dermatology and Venerology, Oslo University Hospital, Oslo, Norway

    José Hernán Alfonso

  5. Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Health Sciences Centre, Hamilton, ON, Canada

    Andrea Nardelli

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  1. Juan Pedro Russo
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  2. José Hernán Alfonso
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Editors and Affiliations

  1. Department of Dermatology, Universitat Autònoma and Universitat Pompeu Fabra de Barcelona, Barcelona, Spain

    Ana M. Giménez-Arnau

  2. Department of Dermatology, UCSF Medical Center, San Francisco, CA, USA

    Howard I. Maibach

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Russo, J.P., Alfonso, J.H., Nardelli, A. (2023). Work-Related and Occupational Hand Eczema (OHE), Diagnosis and Treatment. In: Giménez-Arnau, A.M., Maibach, H.I. (eds) Handbook of Occupational Dermatoses. Updates in Clinical Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-031-22727-1_10

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  • DOI: https://doi.org/10.1007/978-3-031-22727-1_10

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