How should hand eczema be examined?

Hand eczema is a widespread disease that leads to high health care costs and a decrease in the quality of life. Important risk factors include atopic dermatitis, contact allergy and wet work; the role of a null allele in the complex filaggrin gene remains to be clarified The clinical stage of the disease and the examination are essential points in the investigation of hand eczema. Skin tests are indispensable in most cases, while in some it is necessary to go beyond simple patch-tests. Irritant dermatitis is common in comparison with contact allergies and constitutes an important diagnostic pitfall. (C) 2014 Elsevier Masson SAS. All rights reserved.