Hand eczema is a common and distressing condition. Most of the cases of hand eczema have a multifactorial etiology. Endogenous causes of hand eczema are atopic dermatitis, discoid eczema, hyperkeratotic eczema and pompholyx. The most common external cause of hand eczema is the contact with the irritant or mild toxic agents. The diagnosis of hand dermatitis is determined by a review of patient's medical history, a physical examination including other body sites as well as the hands, and a thorough overview of patient's daily activities with emphasis on occupation and hobbies. As clinical differentiation between chronic allergic and irritant hand eczemas is often impossible, patch testing becomes an important diagnostic tool for identification of the probable allergens responsible for eczema.
