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Review
. 2025 Nov;93(5):1201-1210.
doi: 10.1016/j.jaad.2024.09.048. Epub 2024 Oct 5.

Hand eczema-Part 1: Epidemiology, pathogenesis, diagnosis, and work-up

Robert Bissonnette  1 , Tove Agner  2 , Sonja Molin  3 , Emma Guttman-Yassky  4
Affiliations
Review

Hand eczema-Part 1: Epidemiology, pathogenesis, diagnosis, and work-up

Robert Bissonnette et al. J Am Acad Dermatol. 2025 Nov.

Abstract

Hand eczema (HE), also referred to as hand dermatitis, is a frequent medical condition that can have an important negative impact on quality of life. Occupational HE is an important cause of medical disability. Multiple inflammatory pathways are upregulated, and barrier genes are downregulated in HE. Atopic dermatitis and wet work are 2 important risk factors for HE. Clinical presentation can be variable and location may comprise palmar and dorsal aspects, fingers, fingertips, and wrists of one or both hands. Work-up is directed at identifying causative factors and excluding other diagnoses. The first article of this CME series focuses on epidemiology, etiopathogenesis, differential diagnosis, work-up, and patch testing.

Keywords: dermatitis; eczema; hand; hand dermatitis; hand eczema.

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Conflict of interest statement

Conflicts of interest Dr Bissonnette is an advisory board member, consultant, speaker, and/or investigator for and receives honoraria and/or grants from AbbVie, Arcutis, Arena Pharma, Asana BioSciences, Bellus Health, Bluefin Biomedicine, BioMimetix, Boehringer-Ingelheim, Boston, Brickell, CARA Therapeutic, Clexio, Dermavant, Eli Lilly, EMD Serono, Evidera, Galderma, GlaxoSmithKline, Incyte, Inmagene Bio, Janssen, Kiniksa, Kyowa Kirin, LEO Pharma, Novan, Novartis, Pfizer, Ralexar, RAPT Therapeutic, Regeneron, Respivant, Sanofi, Sienna, Target RWE, and Vyne Therapeutics; and is also an employee and shareholder of Innovaderm Research. Dr Agner has received honoraria as advisory board member, consultant, speaker, and/or investigator for Abbvie, Almirall, LEO Pharma, Eli-Lilly, Pfizer, Novartis, and Sanofi. Dr Molin has received honoraria as consultant/advisor or speaker and/or grants from Abbvie, Almirall, Aralez, Arcutis, Basilea, Bausch and Lomb, Bristol Myers Squibb, Boehringer-Ingelheim, Evidera, Galderma, GSK, Incyte, LEO Pharma, Lilly, Novartis, Pfizer, Sanofi, Sun Pharma, and UCB. She is currently an investigator for Novartis and LEO Pharma. Dr Guttman-Yassky is an employee of Mount Sinai and has received research grants from Boehringer Ingelheim, Leo Pharma, Pfizer, Cara Therapeutics, UCB, Kyowa Kirin, RAPT, Amgen, GSK, Incyte, Sanofi, Bristol Myers Squibb, Aslan, Regeneron, Anaptysbio, Concert, Janssen, and is a consultant for Abbvie, Almirall, Amgen, AnaptysBio, Apogee Therapeutics, Apollo Therapeutics Limited, Artax Biopharma IncAstraZeneca, Bristol Myers Squibb, Boerhinger-Ingelhiem, Cara Therapeutics, Centrexion Therapeutics Corporation, Connect Biopharm, Eli Lilly, Enveda Biosciences, Escient Pharmaceuticals, Inc, Fairmount Funds Management LLC, Forest Laboratories Galderma, Gate Bio, Google Ventures (GV), GSK Immunology, Horizon Therapeutics USA, Inc, Incyte, Inmagene, Janssen Biotech, JT Central Pharmaceutical Research Institute, Jasper Therapeutics, Kyowa Kirin, Leo Pharma, Merck, Nektar Therapeutics, Novartis Pharmaceuticals Corporation, NUMAB Therapeutics AG, OrbiMed Advisors LLC, OTSUKA, Pfizer, Pharmaxis Ltd, Pioneering Medicine VII, Inc, Proteologix US Inc, RAPT, Regeneron Pharmaceuticals, RibonTherapeutics, Inc, Sanofi, SATO, Schrödinger, Inc, Sun Pharma Advanced Research Company (SPARC), Teva Branded Pharmaceutical Products R&D, and UCB.