LAUSR

Hand eczema (HE) is a disabling skin condition with high prevalence, a morbidity which strongly impacts the quality of life of affected individuals. A 1-year prevalence of HE is 9.1% in general population. The incidence and prevalence of HE in general population of children are largely unknown because only a few systematic studies in unselected populations were undertaken. A point prevalence of contact allergy of 15.2% was found among 1146 8 grade school children in Odense, Denmark. In Scandinavian school children, the 1-year prevalence of HE was 7.3% for children aged 12–16 years and 10.0% for adolescents aged 16–19 years. Gronhagen et al. reported the self-reported lifetime prevalence of HE at the age of 16 to be 9.7%. Although prevalence of pediatric HE is increasing, cases remain underreported. Reports suggest that more than 75% of diagnosed children with allergic contact dermatitis (ACD) are more than ten years old, although ACD can occur in infancy. Wang et al. presented very interesting data on life-time prevalence of HE and associations between potential endogenous and exogenous factors in a cohort of 15-year-old adolescents from Germany. It was a cross-sectional study conducted in four regions of Germany, which recruited 3097 healthy neonates, and 56.1% of the parents or families completed the follow-ups. After delivery, the parents were asked to complete questionnaires every year until the children were 14 years old and to report whether the children had been diagnosed with an allergy-related disease or its relevant clinical symptoms in the previous 12 months. All the data were based on questionnaires and blood tests (immunoglobulin E). From the birth cohort, 84.6% children had completed the 15-year follow-up and reported whether they have ever had HE. The lifetime prevalence of HE among adolescents at the age of 15 was 10.4%, with a significantly higher lifetime prevalence among girls than boys. Their study showed that likelihood of a first occurrence of HE gradually increases with age. Etiological background for HE can be explained by exogenous exposures or endogenous factors (e.g., impaired skin barrier function). According to Wang et al. asthma, IgE positivity for food and inhalant allergens and other lifestyle factors (e.g., reports of daily showering, daily usage of body cream and daily exposure to familial cigarette smoking indoor) were not associated with occurrence of HE. Previous studies indicate that smoking may cause an increased frequency of HE, particularly in high-risk occupations, but data are mostly conflicting. Neither the current study nor the Danish cohort could confirm that relationship, and this inconsistency may differentiate between active and passive smoking. Passive smoking was the main exposure in this cohort. Both atopic dermatitis (AD) and HE are common chronic and relapsing inflammatory skin conditions often co-occurring. History of AD and wet work are significant risk factors for HE. Patients with AD have a 3to 4-fold increased prevalence of HE when compared with controls. Wang et al. indicated statistically significant associations between the lifetime prevalence of HE among the adolescents having ever been diagnosed with AD or having ever had dry skin, respectively, but no statistically significant associations were found between exogenous factors and HE. Results from the Wang et al. study are very important and useful. They indicate that HE constitutes a significant burden in pediatric populations because one out of ten participants ever suffered from HE until age of 15. The identification of such cases in pediatric population is very important for helping both clinicians and parents to diagnose and prevent HE by providing early interventions, treatments, thus improving quality of life.