Patch Testing in Chronic Hand Eczema: A Multicentre Study in Portugal

ABSTRACT Background Chronic hand eczema (CHE) is a common dermatitis with morphological and aetiological heterogeneity. Allergic contact dermatitis (ACD) is a major aetiology, and patch testing (PT) is essential to characterize CHE and guide its treatment and prevention. Objectives Determine the prevalence of ACD in CHE patients, describe relevant allergens, and identify differences in atopic and occupational settings. Methods We conducted a multicentric retrospective observational study, based on PT results of CHE patients evaluated between 2021 and 2023, in Portuguese dermatology departments, comparing atopic dermatitis and non‐atopic and occupational and non‐occupational groups. Results Among 1267 patients (391 males/876 females) with CHE, representing 43% of all patients tested, 57% had at least one positive PT reaction, 41% of which were currently relevant. The most common allergens included metals, preservatives, fragrances, rubber constituents and 2‐hydroxyethyl methacrylate. The occupational group revealed higher relevance rates for metals and benzisothiazolinone, whereas in the atopic dermatitis group, methylisothiazolinone and Myroxylon pereirae were considered more frequently relevant. Conclusions CHE patients present a high sensitization rate and ACD is a main aetiology. Methylisothiazolinone and 2‐hydroxyethyl methacrylate are confirmed as emergent allergens. The higher relevance rate of metals and benzisothiazolinone in the occupational group reinforces the importance of PT in the occupational setting.