Etiology and prognosis of hand eczema in a dermatology clinic in China: a follow-up study.

Background: Prognosis of hand eczema (HE) has not been reported in China.

Objective: To investigate the etiology and outcome of HE in 655 consecutive patients patch tested with European standard series in Peking University Hospital in a 2-year period.

Methods: All patients were re-examined at 1 year after patch testing, and prognosis of dermatitis was evaluated by the rate of clearance of skin symptoms for at least 3 months without relapse before the evaluation.

Results: Of 599 patients examined, 82 (13.7%) were HE. Allergic, irritant, and unclassified HE accounted for 23.2%, 17.1%, and 51.3% of HE, respectively. The overall clearance rate of HE was much lower than that of eczema elsewhere (18.3% versus 29.6%, P < 0.05, chi-squared test). 35.7% of patients with allergic HE and 26.3% with irritant HE cleared their lesions, of those with unclassified HE only 11.9% (P < 0.05, chi-squared test). The lowest healing rate (5.7%) was found in unclassified HE patients with disease duration over 6 months.

Conclusions: The outcome of HE was worse than eczema elsewhere. Allergic HE had a better prognosis than unclassified HE. Longer disease duration was the main risk factor for poor prognosis of unclassified HE.