A Study of Clinico-Pathological and Allergological Correlation in Chronic Palmar Eczema

Abstract

Introduction: Hand eczema is a diagnostic term used to describe dermatitis primarily affecting the hands. It can stem from both internal (endogenous) or external (allergic or irritant) factors. The majority of cases involve a combination, where external triggers exacerbate the condition in individuals predisposed to such reactions due to internal factors. It is crucial to identify and avoid contact with triggers for effective management. Patch testing is used to pinpoint the allergens responsible for allergic contact dermatitis. 

Methodology: A cross sectional study  was done in 110 patients of chronic hand eczema attending out-patient Department of Dermatology in Sri Manakula Vinayagar Medical College and Hospital over a period of  one and half year. Socio- demographic and clinical data were recorded from all the patients after getting informed consent. For all suspected cases biopsies were taken to confirm the diagnosis and were subjected to patch test with standardized patch test series (CODFI series).

Results: Mean age among the participants was 40.2 ± 13.6 years, with males having a mean age (SD) of 38.8 ± 13.7 years and females having a mean age (SD) of 41.4 ± 13.6 years. Among them 53% were women and 47% were males. Housewives (31%) were the most commonly affected. Hyperkeratotic type was the most common morphological pattern seen in 42.7% of patients followed by wear and tear type in 22%. Patch test positivity was seen in 72.7% of patients. Paraphenylenediamine (PPD) was found to be the most common allergen seen in 29%. This was followed by parthenium (21%), Potassium dichromate (17%), and fragrance mix (4.5%).

Conclusion: Understanding the diverse causes and clinical manifestations of hand eczema, along with targeted allergen identification through patch testing, is essential for effective management and prevention strategies in affected populations.