Patients With Hand Eczema Report High Levels of Stress

Eczema on a woman's hand
Eczema on a woman’s hand
The clinic-etiological factors of patients with hand eczema were assessed.

Many patients with hand eczema report high levels of stress, suggesting stress management should be integrated into eczema management, a study published in Dermatologic Therapy suggests.

Researchers from India enrolled 62 patients with hand eczema in this descriptive study to investigate the clinic-etiological factors associated with the disease. Patients were recruited from an outpatient department at a single tertiary care center. All patients underwent patch testing, and stress levels were examined using the Perceived Stress Scale (PSS).

Hand eczema was predominantly caused by allergic contact dermatitis in approximately 59.7% of patients (n=37). Patch test positive results were seen in 66.1% (n=41) of patients. In patients with atopic dermatitis, the mean number of allergens with positive patch test results was 1.68±1.73 compared with 2.33±1.79 in patients without atopic dermatitis. In terms of the most common allergens, differences in the sexes were observed, with potassium dichromate being the common allergen in men vs fragrance mix in women.

Significant levels of stress were reported in 67.7% of patients, according to responses on the PSS questionnaire, with 51.6% reporting high stress levels and 16.1% reporting very high stress levels. A higher percentage of patients with increased stress scores were men (59.5%) vs women (40.5%). No significant association was found in morphological subtypes and the identified etiologies.

A limitation of this study was the lack of a causative analysis to determine whether stress increases eczema flares or is simply a result of the disease.

The investigators concluded that they “recommend stress management should be applied as a part of the treatment in patients with hand eczema.”


Janardhanan AK, Sukumarakurup S, Abdul Latheef EN, et al. Therapeutic considerations related to stress levels associated with hand eczema: A clinico-etiological study. Published online November 5, 2020. Dermatol Ther. doi:10.1111/dth.14508