Psychodermatologic Features of Hand Dermatitis in Adolescents With and Without Obsessive-Compulsive Disorder

Background: Hand dermatitis (HD) in adolescence is a multifactorial inflammatory condition in which repetitive cleansing behaviors, emotional distress, and psychodermatologic factors may be associated with disease persistence and clinical burden. Objective: To compare dermatologic severity, clinical characteristics, neurocognitive functioning, and emotional-behavioral features among adolescents with obsessive-compulsive disorder (OCD), HD, or their co-occurrence. Methods: A total of 139 adolescents were categorized into HD only, OCD + HD, and OCD only. Standardized measures assessed premorbid functioning, neurocognition, and emotional-behavioral symptoms. Group differences were examined using ANOVA/ANCOVA and chi-square tests, and logistic regression identified predictors of OCD comorbidity among adolescents with HD. Results: The OCD + HD group demonstrated a significantly shorter onset-diagnosis interval than both comparison groups. Global functioning was highest in the HD-only group, while OCD groups showed better verbal learning and fluency. Anxiety, depressive symptoms, and OCD severity were higher in OCD groups. Hand Eczema Severity Index scores were significantly higher in the OCD + HD group, which also demonstrated more frequent fissuring, xerosis, and recurrent irritant-pattern lesions during dermatologic examination. Exploratory logistic regression analyses indicated that shorter onset-diagnosis interval (OR = 0.79, P = .013), poorer premorbid peer functioning (OR = 2.22, P = .003), and longer treatment duration (OR = 1.21, P = .004) were associated with OCD comorbidity among adolescents with HD. Conclusion: Adolescents with comorbid OCD and HD may represent a clinically distinct psychodermatologic subgroup characterized by greater dermatologic severity and elevated emotional symptom burden. Recognition of behavioral and psychiatric features in adolescents with recurrent or treatment-resistant HD may support earlier multidisciplinary intervention.