Epidemiological, Clinical and Allergic Profile of Patients With Dyshidrotic Eczema (Acute and Recurrent Vesicular Dermatitis): Evaluation of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy (REIDAC)

Abstract

BACKGROUND: Dyshidrotic eczema (DE), also termed acute and recurrent vesicular dermatitis, is a vesicular clinical pattern of hand eczema (HE) with heterogeneous aetiologies. OBJECTIVES: To characterise the clinical-allergological profile of patients with DE and to compare it with non-DE HE subtypes. METHODS: A multicentre, retrospective, observational study was conducted using data from the Spanish Contact Dermatitis Registry (2019-2024). RESULTS: Of 4378 patients with HE, 559 were diagnosed with DE. A longer median disease duration (24 vs. 14 months) and more frequent palmoplantar involvement (16% vs. 7%) were observed in DE compared with non-DE HE. At least one positive patch test was identified in 43% of DE versus 52% in non-DE HE. Although overall sensitisation patterns were largely comparable, DE showed lower sensitisation rates to 2-HEMA, carba mix and thiuram mix. Occupational factors were less frequently implicated in DE (9% vs. 29%) compared with non-DE HE. CONCLUSIONS: Despite a high overall frequency of contact allergen sensitisation, the pattern of findings suggests that the dyshidrotic phenotype may follow a clinical course less dependent on external or occupational triggers, pointing towards a relatively greater contribution of endogenous factors compared with other HE subtypes.