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This information is intended for education of both the general public and healthcare professionals. If you are experiencing any symptoms please discuss the best treatment options with your doctor.

Understanding Chronic Hand Eczema

Chronic Hand Eczema is characterized by the clinical signs of erythema, vesicles, papules, scaling, fissures, and hyperkeratosis.¹ The core symptoms are itch and skin pain, which patients report to be the among the most burdensome.^1,2

These signs and symptoms can fluctuate over time and patients can experience recurring flares, which are often in response to an exogenous trigger such as repetitive hand washing but can also occur around periods of stress.^2–4

Not an actual patient

Risk factors 

Several risk factors have been identified and relate to biology, environment, and lifestyle:¹

Biological factors

Female sex^1,5
• Hand eczema is up to twice as high in females vs males⁵
Atopic dermatitis¹
Childhood eczema¹
Early onset of symptoms¹
Mutations in the gene encoding filaggrin, a skin barrier protein¹
Contact allergy¹

Environmental factors

Occupational exposure¹
• The incidence of hand eczema is greater in occupations such as nursing, that involve prolonged contact with irritants such as water, soap, and gloves^1,6,7
Domestic exposure
• Prolonged wet work due to domestic tasks such as cleaning and childcare^1,8,9
• This has been suggested to be part of the reason why hand eczema is more prevalent in females^8,9
Cold/dry weather conditions¹

Behavioural and socioeconomic factors

Tobacco use¹
Stress¹
Lower educational level¹

Subtypes

Chronic Hand Eczema is a heterogenous disease with varying morphologic features. It can be divided into several etiological and clinical subtypes.¹

These include irritant contact dermatitis, allergic contact dermatitis, atopic hand eczema, protein contact dermatitis/contact urticaria, hyperkeratotic hand eczema, and recurrent vesicular hand eczema (also known as pompholyx).^1,6

Chronic Hand Eczema has a complex morphological picture and classifying it into these subtypes can be challenging for several reasons:^1,2,6

More than one etiological and clinical subtype may be present in one individual^1,2

Chronic Hand Eczema can evolve over time¹

There is no reliable link between the clinical picture and the underlying etiology^1,6

Each etiological subtype has a unique immune signature; however, there are some shared aspects of the overarching pathophysiology across subtypes.¹⁰

Chronic Hand Eczema pathophysiology

The pathophysiology of Chronic Hand Eczema is characterized by skin barrier dysfunction and inflammation of the skin^10–12

The pathophysiology of Chronic Hand Eczema is characterized by skin barrier dysfunction and inflammation of the skin:^10–12

Skin barrier dysfunction occurs when the uppermost layer of the epidermis — the stratum corneum — breaks down^10–12
- A reduction of structural skin barrier proteins, such as filaggrin, is involved in this process and is associated with increased transepidermal water loss, which further compromises the integrity of the skin barrier^10–12
The breakdown of the skin barrier leads to an inflammatory response^10–12
Allergens, irritants, and microbes can penetrate the disrupted skin barrier^10–12
The resultant infiltration and activation of immune cells causes further inflammation¹⁰

This short animation explains the key aspects of Chronic Hand Eczema pathophysiology, including skin barrier disruption and inflammation of the skin.^10–12

The graphics in this animation have been developed by LEO Pharma and inspired by relevant references used in this animation.

Abbreviations

JAK1/2/3, Janus kinase 1/2/3; JAK-STAT, Janus kinase and signal transducer and activator of transcription; TYK2, tyrosine kinase 2.

Learn more about the causes, triggers, and pathophysiology of Chronic Hand Eczema

The pathophysiology of Chronic Hand Eczema

A short animation explaining the key aspects of Chronic Hand Eczema pathophysiology including skin barrier disruption, inflammation of the skin, and JAK-STAT signaling pathways^10–12,14

Duration: 03.50

Related content

Chronic Hand Eczema overview

Chronic Hand Eczema is a multifactorial, inflammatory skin disease^1,2

The burden of Chronic Hand Eczema

Chronic Hand Eczema can cause visible and functional impairments to the hands, so it can have a profoundly negative impact on patient quality of life^2,7,16,17

Diagnosing Chronic Hand Eczema

Chronic Hand Eczema is hand eczema that lasts for more than 3 months, or relapses twice or more often in a year¹

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