Allergens associated with severe symptoms of hand eczema and a poor prognosis

TY - JOUR

T1 - Allergens associated with severe symptoms of hand eczema and a poor prognosis

AU - Hald, Marianne

AU - Agner, Tove

AU - Blands, Jette

AU - Ravn, Henrik

AU - Johansen, Jean Duus

N1 - Keywords: Adult; Allergens; Chi-Square Distribution; Eczema; Female; Hand Dermatoses; Humans; Logistic Models; Male; Middle Aged; Patch Tests; Photography; Prognosis; Questionnaires; Severity of Illness Index

PY - 2009

Y1 - 2009

N2 - BACKGROUND: Contact allergy is frequent among persons with hand eczema and may be associated with a poor prognosis. OBJECTIVES: To identify allergens associated with the most severe initial clinical symptoms and the worst prognosis in a cohort of hand eczema patients followed for 6 months. METHODS: The study population comprised 799 consecutive hand eczema patients enrolled during January 2006-February 2007. All patients were patch tested with the European baseline series. Severity assessment of the hand eczema was performed initially and at the 6-month follow-up using a validated scoring system (HECSI). With logistic regression analyses, associations of severe hand eczema or a poor prognosis with 15 individual allergens were analysed and adjusted for by sex, age, atopic dermatitis and other allergens. RESULTS: At baseline, greater severity of hand eczema was associated with a positive patch test to formaldehyde, methyldibromo glutaronitrile, sesquiterpene lactone mix, nickel sulfate and potassium dichromate. A poor prognosis was associated with chromate allergy, odds ratio: 4.18 (95% CI: 1.42-12.28). CONCLUSIONS: Nickel, chromate, formaldehyde, methyldibromo glutaronitrile and sesquiterpene lactone mix were allergens associated with the greatest severity of hand eczema. Patients with chromate allergy had the worst prognosis.

AB - BACKGROUND: Contact allergy is frequent among persons with hand eczema and may be associated with a poor prognosis. OBJECTIVES: To identify allergens associated with the most severe initial clinical symptoms and the worst prognosis in a cohort of hand eczema patients followed for 6 months. METHODS: The study population comprised 799 consecutive hand eczema patients enrolled during January 2006-February 2007. All patients were patch tested with the European baseline series. Severity assessment of the hand eczema was performed initially and at the 6-month follow-up using a validated scoring system (HECSI). With logistic regression analyses, associations of severe hand eczema or a poor prognosis with 15 individual allergens were analysed and adjusted for by sex, age, atopic dermatitis and other allergens. RESULTS: At baseline, greater severity of hand eczema was associated with a positive patch test to formaldehyde, methyldibromo glutaronitrile, sesquiterpene lactone mix, nickel sulfate and potassium dichromate. A poor prognosis was associated with chromate allergy, odds ratio: 4.18 (95% CI: 1.42-12.28). CONCLUSIONS: Nickel, chromate, formaldehyde, methyldibromo glutaronitrile and sesquiterpene lactone mix were allergens associated with the greatest severity of hand eczema. Patients with chromate allergy had the worst prognosis.

U2 - 10.1111/j.1600-0536.2009.01577.x

DO - 10.1111/j.1600-0536.2009.01577.x

M3 - Journal article

C2 - 19706050

SN - 0105-1873

VL - 61

SP - 101

EP - 108

JO - Contact Dermatitis

JF - Contact Dermatitis

IS - 2

ER -