Common triggers for eczema on the hand

Acute contact dermatitis is usually triggered by allergens such as nickel, potassium dichromate, as used in shoes, or acrylate, as used in toilet seats. Many people have a contact allergy to nickel, and notice it for the first time when wearing nickel earrings. The main triggers for hand eczema are liquids or gloves.

Diagnosis

Usually, the diagnosis of eczema on the hand is a gaze diagnosis. Either because the scaly, reddish skin change becomes apparent or because the typical, sometimes weeping blister formation has already occurred in the advanced stage. It is also important to exclude the numerous other causes such as scalding or burns by questioning the patient.

A detailed patient survey should also clarify whether such a skin reaction has already occurred and if so, whether the patients can remember after which contact. It is also important to ask whether there are other allergies, such as hay fever, pollen allergy or neurodermatitis, since there is most likely a connection between frequent allergies and contact eczema in the sense of hypersensitivity of the skin or an overactive immune system. Also important and complementary is the question of rheumatic diseases and occurrences of skin diseases in the family.

In dermatology, there are always many borderline cases in addition to gaze diagnoses, where it is not entirely clear whether it is really wine eczema, which is caused by allergies. Especially as it is not necessarily clear what the patient is allergic to.In this case, and especially if suspicious eczema in the area of the hand occurs repeatedly, an allergy test should be done. In this test, the usual eczema-triggering substances are applied to the skin and a corresponding skin reaction is waited for.

The substances are applied on an adhesive strip and are stuck on a skin area, e.g. on the back or back of the hand. This procedure, also known as prick testing, usually involves the allergens animal hair, food, pollen and house dust. After 20-30 minutes the first reactions on the skin can usually be seen and assessed. Depending on which field causes redness, the allergen on it is responsible for the reaction.