Based on medical history, clinical investigation
and patch test results, the following diagnoses
were made (Table 6). Orthoergy (irritant
factors) was the main cause, while contact allergy
played only a secondary role. The combination
of contact allergy with orthoergy was
most frequently seen in women (53%).
The main allergens were (Table 5): nickel
(5), cobalt (4), chrome (3) and rubber chemicals
(2). Positive patch tests to cleaning agents
were rare. Only one to Stafilex (sodium dichloro-iso-cyanurate)
and one to lysol were
found. Control tests with both substances on
20 normal persons were negative.
In cases of possible mycotic infection, a direct
preparation and culture were performed.
In 2 persons (both men) tinea of the hand and/
or fingernails was diagnosed.
Table 6. Subgroups of eczema
irritant
irritant + allergic
irritant + atopic
mycotic
mycotic + allergic
unclassified
Grade I
men women
21 (80%) 5 (100%)
1(4%)
4 (16%)
Table 7. Protection of the skin during/after work (43
cases of hand eczema)
During work After work
men women men women
no protection 38% 19% 31% 12%
cream/ointment 38% 59% 69% 88%
gloves 23% 24%
Concerning the duration of the eczema,
88% were of a duration longer than 2 years
(95% men and 94% women), 12% were of a
duration shorter than 2 years, and 5% started
during the last 6 months.
31 of 43 persons with eczema (72%) acquired
their skin complaint during their occupation
as a cleaner. In 12, the eczema had
started in a previous job, but one had changed
occupation because of it.
The major part of all cleaning work is performed
manually with very frequent and intensive
contact with water. All persons with eczema
were asked about using some kind of
protection during and/or after work. (A special
hand cream is provided by the hospital and
gloves are available where they are needed.)
Table 7 shows that gloves were not used
very frequently (23%). Hand cream was used
more often, during as well as after work.
Women used hand creams more than men, and
particularly more drug store products.