Prevalence, incidence and course of eczema on the hands and forearms in a sample of the general population

Abstract

In 1979, the inhabitants of a geographically defined area [of the Netherlands] were examined for skin disorders of the hands and forearms. In 1982 this cohort was invited for reexamination. In persons with eczema, patch testing was performed. Irritant factors had a role in 73% of the cases while a contact allergy was detected in 30%. The most frequent allergens were NiSO4 (20%), K2Cr2O7 (6%) and CoCl2 (4%). In some persons with a definite history of allergy to metals, no positive patch test with Ni, chromate or Co could be obtained; other mechanisms may be involved. Significantly more positive patch tests were found among persons with an eczema of longer than 2 yr duration compared with persons with eczema present for a shorter period of time, indicating that many cases of eczema are primarily of irritant nature but later complicated by sensitization. In 41%, the eczema was healed. A poor healing tendency was observed in those with a combination of irritant and allergic eczema. Relatively few ascribed healing to medical treatment.