Das Handekzem ist eine multifaktorielle Hauterkrankung. Eine genetische Prädisposition,
die spezifische Exposition und insbesondere berufliche Aspekte sollten im Management
der Patienten berücksichtigt werden. Dieser Beitrag thematisiert wichtige Aspekte
des diagnostischen Vorgehens, der Prävention und der therapeutischen Möglichkeiten
in Abhängigkeit von Ätiologie und Schwere des Handekzems.
Abstract
Hand eczema is a multifactorial skin disease. Therefore, genetic predisposition, exposure
to risk factors and, in particular, occupational circumstances should be considered
in patient care. This article discusses diagnostic approaches, prevention and options
for therapeutic intervention for hand eczema of different etiology and severity.
Hand eczema is a socially significant disease because of its high prevalence, morbidity
and impact on professional life. Clinical manifestations are diverse and include vesiculous
and erosive as well as hyperkeratotic and desquamative variants. The diagnostic work-up
of hand eczema and its differential diagnosis requires a detailed assessment of occupational
and recreational exposure. Exposure to a contact allergen is often a contributing
factor. Therefore all patients with hand eczema persisting more than three months
should undergo patch testing. In case of possible work-related triggers the accident
insurer should be informed early (via the dermatologist’s report). An escalating treatment
approach depending on disease severity and chronicity is necessary. Elimination of
individual trigger factors and optimizing preventive measures is important. In the
future patients may benefit from new therapeutic agents such as biologics for the
treatment of atopic eczema and topical Janus kinase inhibitors.
Schlüsselwörter
Kontaktekzem - stadiengerechte Therapie - irritatives Kontaktekzem - Berufsdermatose
- atopisches Ekzem
Keywords
contact eczema - stepwise treatment - irritant contact dermatitis - occupational dermatosis
- atopic dermatitis
