ABSTRACT
I. Introduction 249
II. Definition 249
III. Diagnosis 251
A. Hazardous Exposures 252
B. Ways of Exposure 253
C. Determination of Hazardous Potential 254
D. Localization of Eczema 255
E. Course of Eczema 255
F. Diagnostic Problems 256
1. Concealed Hazardous Exposure 256
2. Infrequent Hazardous Exposure 257 3. No Demonstrable Hazardous Factor 257
4. Multifactorial Background 258 5. Endogenous Dermatitis 260
6. Nonoccupational Hazardous Exposure 261
a. Sensitizers 260
b. Irritants 261
7. Postoccupational Eczema 263
IV. Summary 264
References 264
I. INTRODUCTION
For dermatologists, and even for general practitioners, hand eczema is a common cause for consultation. Of course, this reflects the fact that hand eczema is common in the general population, but it probably also reflects the profound effects hand eczema may have occupationally and socioeconomically, both in terms of influence on beginning a job as well as the possibility of continuing a particular job, and causation of various disturbances of daily life activities.1,2
In an industrial city the 1 -year period prevalence of hand eczema was estimated to be around 11% and the prevalence at a certain time 5.4%.1 In a Finnish population of approximately 1000 persons, the hands were examined and eczema was found in 4%.3 A cumulative hand eczema incidence of 22% was reported in a sample of Danish women.4 In two samples of the general population in the Netherlands a 3-year period prevalence of hand eczema was found to be 6 to 7%.5
