ABSTRACT
The incidence of atopic hand eczema differs greatly in published reports depending on differences in the populations studied or, probably more importantly, on different criteria for atopy. In a large epidemiological study on hand eczema, Meding and Swanbeck1 found 22% atopic hand eczema using the criteria “a history of previous atopic dermatitis or present atopic dermatitis at other sites on the body.” In a patient material of hand eczema, Svensson2 found an atopic background of 33% if the criteria were previous or present flexural dermatitis; if an elaborate point system were used, atopic hand eczema was diagnosed in 49%. Similarly high figures were obtained in occupational as well as nonoccupational patients in a German hand eczema material.3 Conversely, it is well known that patients with atopic dermatitis in childhood, if still affected as adults, have their eczema localized to hands to a high degree.4,5
II. CLINICAL PROFILE
The atopic hand eczema has no uniform clinical picture. Still the experienced dermatologist, supported by some anamnestic information, recognizes the entity
and establishes the diagnosis. The distribution is almost always symmetric. In many cases, however, the picture is obscured by one or several exogenous factors. It should always be kept in mind that a patient with a previous atopic skin disease is prone to develop an irritant, traumiterative dermatitis of the hands or, vice versa, that a majority of patients with an irritant hand eczema have an atopic background.
