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Structured diagnostic assessment of hand eczema in cleaning workers
Author(s) -
Jamiolkowski Dagmar,
StevelingKlein Esther,
Thomas ZitaRose Manjaly,
Bircher Andreas,
Hofmeier Kathrin Scherer,
Hartmann Karin
Publication year - 2021
Publication title -
jddg: journal der deutschen dermatologischen gesellschaft
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 60
eISSN - 1610-0387
pISSN - 1610-0379
DOI - 10.1111/ddg.14452
Subject(s) - contact dermatitis , patch testing , dermatology , irritant contact dermatitis , medicine , patch test , allergic contact dermatitis , contact allergy , allergen , allergy , immunology
Summary Hand dermatitis is a widespread problem among cleaners. In most cases, it is caused by a combination of wet work and contact with irritants, which can result in irritant (toxic) contact dermatitis. In some cases, the irritant contact eczema then evolves into allergic contact dermatitis, although not all cases of allergic contact dermatitis are preceded by irritant contact dermatitis. This mini‐review proposes a two‐step diagnostic algorithm based on patch testing, which can be used if allergic contact dermatitis is suspected in cleaning workers. As a first step, we recommend performing the DKG standard series (German Contact allergy research group, DKG), the DKG rubber series, both DKG “further fragrances” series as well as the DKG preservative and disinfectant series. If there are clear hints of an occupational contact dermatitis, the first step can also involve testing patients’ own products alongside the standardized tests. In a second step (at the latest), if standardized tests do not suffice to identify the culprit allergen and there is well‐founded suspicion, we recommend testing the patients’ own products. If necessary, the second step can also include testing the individual contact allergens contained in the screening mixes that are part of the standard series.