[Pathogenesis of hand eczema]

Abstract

Background: The pathogenesis of hand eczema is multifactorial. Exogenous factors such as skin irritation and contact sensitization contribute to this as well as an endogenous atopic predisposition.

Objective: This article provides a review of the pathogenetic factors relevant to the development of hand eczema.

Material and methods: An evaluation of the current literature on the pathogenesis of hand eczema was carried out.

Results: Impairment of the epidermal barrier function plays an essential role for the development of hand eczema. The molecular biological basis and the possible significance of a genetic predisposition beyond atopy are not yet fully understood. Immunological processes involved in the pathogenesis of allergic contact dermatitis and atopic eczema are likely to play a role in the development of certain subtypes of hand eczema. This might contribute to an expansion of the therapeutic armamentarium for hand eczema in the future.

Conclusion: The exact understanding of the individual pathogenesis in single hand eczema patients is essential in order to provide specific advice on allergen avoidance, skin protection and basic treatment and to initiate appropriate therapeutic measures.

Keywords: Atopy; Contact sensitization; Epidermal skin protection barrier; Immunological processes; Irritative contact dermatitis.