Contact dermatitis of the hands: Cross-sectional analyses of North American Contact Dermatitis Group Data, 1994-2004

Erin M. Warshaw, Rehana L. Ahmed, Donald V. Belsito, Vincent A. DeLeo, Joseph F. Fowler, Howard I. Maibach, James G. Marks, C. G. Toby Mathias, Melanie D. Pratt, Robert L. Rietschel, Denis Sasseville, Frances J. Storrs, James S. Taylor, Kathryn A. Zug

Research output: Contribution to journalArticlepeer-review

86 Scopus citations


Background: Hand dermatitis, including irritant and allergic contact dermatitis (ACD), is common. Objective: To evaluate allergens, relevant irritants, sources and occupations associated with hand contact dermatitis using North American Contact Dermatitis Group (NACDG) data. Methods: A cross-sectional analysis of 22,025 patients patch tested between 1994 and 2004. Results: Hand involvement was found in 6953 patients; 959 had ACD as the only diagnosis. In these 959 patients, the 12 most frequent relevant allergens were quaternium-15 (16.5%), formaldehyde (13.0%), nickel sulfate (12.2%), fragrance mix (11.3%), thiuram mix (10.2%), balsam of Peru (9.6%), carba mix (7.8%), neomycin sulfate (7.7%), bacitracin (7.4%), methyldibromoglutaronitrile/phenoxyethanol 2.0% (7.4%), cobalt chloride (6.5%), and methyldibromoglutaronitrile/phenoxyethanol 2.5% (6.3%). Rubber allergens were most commonly associated with occupation. One third of patients with hand ACD had identifiable relevant irritants. Limitations: Cross-sectional analyses prevent evaluation of causal associations. Conclusion: In NACDG patients with hand ACD, the most common allergens included preservatives, metals, fragrances, topical antibiotics, and rubber additives.

Original languageEnglish (US)
Pages (from-to)301-314
Number of pages14
JournalJournal of the American Academy of Dermatology
Issue number2
StatePublished - Aug 2007

All Science Journal Classification (ASJC) codes

  • Dermatology


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