Dermatologic examination
All individuals with a positive questionnaire diagnosis for
hand dermatitis were asked to co-operate in a dermatologic
examination. It included a standardized interview
and registration of objective skin symptoms of the hands.
The symptoms were ranged using the following classification:
'active hand dermatitis' (= 'major' dermatitis),
'the first symptoms of dermatitis' (= 'minor' dermatitis),
'no hand dermatitis' and 'other skin disorders'. The
symptoms of major dermatitis were defined as erythema,
papules, vesicles and fissures, comprising a clear eczematous
picture. Minor dermatitis was exhibited as
erythema, slight chapping of the skin and scaling.1
Smit13
found in her validation study of the questionnaire with
nurses, a sensitivity of 100%. Thus, nobody with a negative
questionnaire diagnosis had a positive diagnosis at
the dermatologic examination. For that reason, we did
not do a dermatologic examination in individuals with
a negative questionnaire diagnosis.
During this examination the workers were asked for
their opinion on the benefit of wearing gloves. In addition,
workers were scored on the basis of the standardized
interview in combination with the information from
the questionnaire as 'possibly sensitized', 'dubious' and
'probably not sensitized' for tulipalin A. These scores
were compared with the results of the patch tests.