Hand eczema is often multifactorial, which makes identifying the causes difficult:
(1) allergic reaction to environmental antigens
(2) generalized patient atopy
(3) direct chemical toxicity
(4) abrasion and physical trauma
(5) secondary infections
(6) irritation or aggravation of existing skin lesions
Risk factors for hand eczema:
(1) female gender
(2) working in a humid or wet environment
(3) wearing rubber or latex gloves
(4) working with cleaning solutions or chemicals
(5) working with food
(6) application of topical medications
(7) contact with materials at work
(8) presence of pre-existing skin dermatosis involving the hands, especially with broken skin
(9) history of atopic dermatitis
(10) working with metals, especially nickel compounds
Recommendations:
(1) Reduce or avoid precipitating factors as much as possible.
(2) Wear gloves to protect the hands from environmental agents. If there is a history of rubber or latex sensitivity then latex-free gloves should be worn.
(3) Protect breaks in the skin or existing skin lesions.
(4) Perform patch testing for nickel sensitivity if there is a history of metal sensitivity.
(5) Perform patch testing to determine sensitivities to chemicals or topical drugs.
