Clinical Characteristics of Hand Eczema and its Association with Atopic Dermatitis in the Chinese Population: A Multicenter Cross-Sectional Study

J Invest Dermatol. 2025 Dec;145(12):3089-3099.e7. doi: 10.1016/j.jid.2025.04.031. Epub 2025 May 19.

Abstract

Despite growing awareness on hand eczema (HE) in Western countries, public attention to HE in China is limited. We aimed to investigate the clinical characteristics of HE and examine its association with atopic dermatitis in the Chinese population. A multicenter cross-sectional study was conducted across 23 tertiary hospitals in China between September 2018 and November 2019. Patients with HE completed a survey covering demographics, allergic diseases, and HE-specific characteristics and underwent patch testing. Clinical severity was assessed using the Hand Eczema Severity Index. Binary logistic and linear regression models were used. In total, 2072 patients with HE were included (mean age = 39.8 years, 60.6% female). The most common HE subtype was allergic contact dermatitis, followed by irritant contact dermatitis. One third had moderate-to-very-severe HE, and at least 64.3% had chronic HE. The positive patch test rate was 50.7%. Approximately one quarter had a physician-confirmed diagnosis of atopic dermatitis that was associated with greater HE severity, longer persistence of HE, higher disease burden, and altered contact sensitization patterns in patients with HE. This study indicates that addressing both HE and atopic dermatitis might improve prognosis and QOL for affected individuals, emphasizing the need for targeted preventions and management strategies for this patient population.

Keywords: Atopic dermatitis; Chinese; Clinical epidemiology; Contact sensitization; Hand eczema.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • China / epidemiology
  • Cross-Sectional Studies
  • Dermatitis, Allergic Contact* / diagnosis
  • Dermatitis, Allergic Contact* / epidemiology
  • Dermatitis, Atopic* / diagnosis
  • Dermatitis, Atopic* / epidemiology
  • East Asian People
  • Eczema* / diagnosis
  • Eczema* / epidemiology
  • Female
  • Hand Dermatoses* / diagnosis
  • Hand Dermatoses* / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Patch Tests / statistics & numerical data
  • Quality of Life
  • Severity of Illness Index
  • Young Adult

Supplementary concepts

  • Chinese people