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. 2023 Oct;89(4):270-276.
doi: 10.1111/cod.14384. Epub 2023 Jul 18.

The role of bacterial colonisation in severity, symptoms and aetiology of hand eczema: The importance of Staphylococcus aureus and presence of commensal skin flora

Maria Chapsa  1 , Henriette Rönsch  1 , Tobias Löwe  2 , Florian Gunzer  2 , Stefan Beissert  1 , Andrea Bauer  1
Affiliations

The role of bacterial colonisation in severity, symptoms and aetiology of hand eczema: The importance of Staphylococcus aureus and presence of commensal skin flora

Maria Chapsa et al. Contact Dermatitis. 2023 Oct.

Abstract

Background: The role and causality of the microbial ecosystem on the skin in relation to the development of hand eczema (HE) is still unknown.

Objectives: To investigate the prevalence of different bacterial colonisations in HE patients and their association with the severity, symptoms and aetiology of the disease.

Methods: In a retrospective cohort study of 167 HE patients, bacterial swabs from lesional skin were collected for culturing. Patients were categorised according to bacterial colonisation, HE severity, HE symptoms and HE aetiology.

Results: The majority of the patients were tested positive for Staphylococcus aureus (S. aureus) (n = 131, 78.4%) and/or commensal skin flora (CSF; n = 130, 77.8%), while other bacteria species were found only sporadically. Severe HE was significantly more prevalent in skin with S. aureus (odds ratio [OR]: 5.13, 95% confidence interval [CI]: 2.21-11.94) and less common in skin with CSF (OR: 0.20, 95% CI: 0.05-0.88). S. aureus colonisation was also associated with atopic HE aetiology (p < 0.001) and acute HE symptoms such as blisters, erosions and crusts (p = 0.003).

Conclusions: The main colonisation of HE patients is with S. aureus and is associated with disease severity, acute HE symptoms and atopic HE aetiology. CSF is associated with mild HE, which could result in new therapeutic approaches.

Keywords: Staphylococcus aureus; atopic hand eczema; colonisation; commensal skin flora; hand eczema.

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References

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