[The inappropriateness of the term hand eczema].

The history of the term " hand eczema " goes back some decades to when researchers began to compare the different types of eczemas seen on the hands to analyze their patterns and causes. 1-4 Perhaps to lend this " syndrome " a weightier sound, the term " hand eczema " was invented. 5 Although this was initially an attempt to draw attention to the clinical and etiological diversity of eczema in this location, it ended up covering all the different clinical expressions and etiologies of eczemas found on the hands, such that the impression was given of dealing with an entity per se. Currently, there are a large number of publications in journals and books entitled " hand eczema. " 6-11 The references cited are examples of the most significant, but the number of articles with this title is vast. They clearly describe the various clinical forms of eczema on the hands, their causes, treatment, etc, but when speaking about " hand eczema " they grant it a nosological status that it is utterly devoid of. This is why we end up with reviews of studies that deal with the " treatment of hand eczema, " 12 as if all eczemas that affect the hands could follow a single therapeutic course, or as if we should deal with eczemas of the rest of the body in a very different manner. Some publications describe the treatment of " chronic hand eczema, " 13-15 sometimes without defining what is understood by " chronic. " 13,14 (How many weeks, months or years? Can we describe eczema as chronic when contact dermatitis has been ruled out?) Other studies have assessed the prognosis and quality of life of patients with occupational hand eczema, 16,17 mixing up its multiple causes and without taking into account the difference that exists, for example, between being sensitized to an allergen that, once identified, is easy to avoid at work, or being sensitized to another that makes it completely impossible to carry on working. Thus, it is not surprising that contradictory results are obtained time and time again: a treatment functions perfectly well in some patients, whereas in others it is totally ineffective. The prognosis is excellent in some individuals and extremely poor in others. There is no impact whatsoever on the quality of life in some patients, whereas in others " hand eczema " forces them into depression. …