手指皮膚炎の諸原因，特にその検索法について

PATHOGENESIS OF HAND DERMATITIS

Ⅰ．はじめに

　手指皮膚炎（手指湿疹）の原因は諸家によつて種々検討され，その成因についても多くの論議があるが，今日未だに定説を得ない。これは，

1）手指皮膚炎の定義が一定せず，

In this study the authors have given a diffinition of "hand dermatitis" to be an ec-zmatous dermatitis localized on the hands and fingers, including the dermatitis due to rubber egloves, a wrist watch band or a ring.

About 80% of the patients were female, with the highest incidence in the 2nd and 3rd decades of life. Not a few patients started having the disease or had a recrudescence in summer.

To find causative contactants in daily life, analysis was performed by the following three items; A) environmental factors, B) relationships between the clinical types and causa-tive agents and C) clinical tests composed of patch, photopatch, immersion, and usage tests. In 15 of 42 typical cases causative or aggravating substances were confirmed. The substanceswere detected by item A (54%), C (31%) and B (15%). Rubber, metals and formalin showed higher frequency of positive patch tests in this dermatosis than in the other typse of eczematous dermatitis. Although particular attention must be paid to materials containing the abovementioned substances to find the cause, the results of the patch test alone do not necessarily lend final coinfirmations of contactants. Actually, 88% of the cases gave positive patch tests to some chemical agents which were not causative.

Single immersion in plain water or detergent solutions at an ordinary concentration did not exacerbate the skin lesion. The patch test with detergents at a concentration in ordinary use proved to be negative in all cases. There were no significant differences in the incidence of positive patch tests with undiluted detergens between in the hand dermatitis patients and in control subjects.

Since the normal skin after immersion in water or detergent solutions has a lower thre-shold to contactants, it might be possible that repeated uses of water and detergents would induce indirectly the occurence of hand dermatitis.