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Vol. 88. Num. 6.01 June 2018
Pages 299-356
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Vol. 88. Num. 6.01 June 2018
Pages 299-356
Original Article
DOI: 10.1016/j.anpede.2017.07.007
Hand eczema in children. Clinical and epidemiological study of the population referred to a tertiary hospital
Eccema de manos en niños. Estudio clínico-epidemiológico de la población remitida a un hospital terciario
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José María Ortiz Salvador
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josema.ortiz.salvador@gmail.com

Corresponding author.
, Daniela Subiabre Ferrer, Ana García Rabasco, Altea Esteve-Martínez, Violeta Zaragoza Ninet, Víctor Alegre de Miquel
Servicio de Dermatología, Hospital General Universitario de Valencia, Valencia, Spain
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Tables (5)
Table 1. Classification of hand eczema.
Table 2. Epidemiological characteristics of paediatric patients with hand eczema and paediatric patients with eczema in other locations.
Table 3. Final diagnosis in paediatric and adult patients with hand eczema following epicutaneous testing.
Table 4. Allergens identified most frequently in our case series and percentage of cases in which the allergen was relevant to the eczema.
Table 5. Regions of the hand involved most frequently in patients with hand eczema. The table also shows the distribution based on the presence or absence of ACD.
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Abstract
Introduction

Hand eczema is a frequent disease in adults. Diagnosing the cause of hand eczema is difficult due to different classifications. There is lack of evidence on hand eczema and its causes in children.

Material and method

A total of 389 children between 0 and 16 years were identified between 1996 and 2016, from whom 42 (10.8%) with exclusively hand eczema were selected. In all cases a standard battery of epicutaneous patch tests was performed, as well as additional batteries depending on the clinical suspicion. The clinical and epidemiological features of these children were recorded and compared against children with eczema in other locations.

Results

The 42 children with hand eczema included 25 (59.5%) girls, and 17 (40.5%) boys, with a mean age of 10.6±3.9 years, and did not differ from that of children with eczema in other locations. The definitive diagnosis after patch-testing was Atopic Dermatitis in 15 cases, Allergic Contact Dermatitis in 14 patients, Endogenous Vesiculous Eczema in 6 cases, Endogenous Hyperkeratotic Eczema in 5 cases, and Irritant Contact Dermatitis in 2 cases. The most frequent allergens detected were thiomersal (9 cases), nickel (5 cases), mercury (5 cases), and cobalt (4 cases).

Conclusion

Hand eczema is a common condition in children. The most common cause is atopic dermatitis, although cases of allergic contact dermatitis manifesting as hand eczema are not uncommon. Any child with eczema of hands in whom an allergic cause is suspected should be referred for patch- testing.

Keywords:
Hand eczema
Patch-test
Dermatitis
Eczema
Cutaneous allergy
Resumen
Introducción

El eccema de manos es una forma frecuente de eccema en adultos. Su diagnóstico en ocasiones es complejo debido a la existencia de diferentes clasificaciones diagnósticas. Existen pocos trabajos que estudien el eccema de manos y su clasificación en niños.

Material y método

Se ha identificado a 389 niños entre 0 y 16 años remitidos a la Unidad de Alergia Cutánea de nuestro servicio para estudio con pruebas epicutáneas en el periodo 1996-2016. De entre todos los casos se han seleccionado 42 casos con dermatitis localizada exclusivamente en la mano (10,8% de todos los niños remitidos). En todos los casos se realizaron pruebas epicutáneas parchando la batería estándar, así como baterías adicionales en función de la sospecha clínica. Se recogieron datos epidemiológicos (edad, sexo, antecedentes de dermatitis atópica…), así como clínicos (localización de las lesiones).

Resultados

De los 42 niños remitidos con dermatitis de la mano, 25 (59,5%) eran niñas y 17 (40,5%) niños. La edad media de los pacientes con dermatitis de la mano fue de 10,6 ± 3,9 años. El diagnóstico definitivo tras la realización de pruebas epicutáneas fue dermatitis atópica en 15 casos, dermatitis alérgica de contacto en 14 pacientes, eccema endógeno vesiculoso en 6 casos, eccema endógeno hiperqueratósico en 5 casos y dermatitis irritativa de contacto en 2 casos. Los alérgenos detectados más frecuentes fueron tiomersal (9 casos), niíquel (5 casos), mercurio (5 casos) y cobalto (4 casos).

Conclusión

El eccema de manos es una entidad frecuente en niños. La causa más frecuente es la dermatitis atoípica, aunque no son infrecuentes los casos de dermatitis alérgica de contacto que se manifiestan como eccema de manos. Todo niño con eccema de manos en el que se sospeche una causa alérgica debe ser remitido para realización de pruebas epicutáneas.

Palabras clave:
Eccema de mano
Pruebas epicutáneas
Dermatitis
Eccema
Alergia cutánea

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