Hand Eczema: Patch Testing Important in Diagnosis of Potential Allergens Interview with:

Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois

Dr. Jonathan Silverberg

Jonathan Silverberg, MD, PHD, MPH
Associate Professor
Director of Clinical Research
Director of Patch Testing
George Washington University School of Medicine and Health Sciences
Washington, DC What is the background for this study

Response: Chronic hand eczema was previously shown to be associated with higher rates of allergic contact dermatitis. Yet, little is known about recent trends in North America with respect to the clinical presentation and allergen profile in chronic hand eczema. This study sought to determine the clinical characteristics and etiologies of hand eczema in a large North American cohort of adults referred for patch testing. The patients in the study were patch tested using the North American Contact Dermatitis Group’s allergen screening series. What are the main findings?


Example of Patch Testing
DermNet NZ image

Response: There was a complex overlap of allergic contact dermatitis, irritant contact dermatitis and atopic dermatitis in adult patients with hand eczema. Adults with hand eczema were more likely to have a positive allergic reaction on patch testing compared to those without hand eczema, emphasizing the importance of patch testing in these patients. Hand eczema was associated with a distinct profile of allergens. The five allergens with highest proportion of current relevance were methylisothiazolinone, nickel sulfate hexahydrate, formaldehyde, quaternium-15 and fragrance mix I. What should readers take away from your report?

Response: Patch testing is clinically useful and relevant in adults with hand eczema. Patch testing should be tailored to the needs of hand eczema patients, by including all the most common and relevant allergens. What recommendations do you have for future research as a result of this study?

Response: Future studies are needed to understand more about the allergen profile of hand eczema in children. In addition, future studies are needed to understand how the phenotype of hand eczema impacts the allergen profiles observed.

Any disclosures? None relevant to this study.


Hand Dermatitis in Adults Referred for Patch Testing: Analysis of North American Contact Dermatitis Group Data, 2000–2016
Silverberg, Jonathan I. et al.
Journal of the American Academy of Dermatology, Volume 0, Issue 0

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Last Updated on December 6, 2020 by Marie Benz MD FAAD