Colonization with Staphylococcus aureus in patients with hand eczema: Prevalence and association with severity, atopic dermatitis, subtype and nasal colonization

Contact Dermatitis. 2020 Dec;83(6):442-449. doi: 10.1111/cod.13679. Epub 2020 Sep 21.

Abstract

Background: While Staphylococcus aureus (S. aureus) colonization has been thoroughly studied in atopic dermatitis (AD), where S. aureus is related to flares and considered a trigger factor, S. aureus colonization in hand eczema (HE) has only been sparsely studied.

Objectives: To examine the 1-week prevalence of S. aureus colonization in HE patients, and its association with severity, HE subtype, AD, and nasal S. aureus colonization compared with healthy controls.

Methods: In a case-control study of 50 adult HE patients and 50 healthy controls, bacterial swabs from lesional skin (patients only), non-lesional skin (dorsal hand), and the nasal cavity were sampled for culturing of S. aureus on days 1, 3, 5 and 8. Participants were characterized by demographics, AD, HE subtype, filaggrin gene mutation status, and HE severity.

Results: Twenty-seven HE patients (54%) were colonized with S. aureus on the hand compared to one control (2%) (P < .01). Nasal S. aureus colonization was found in 72% of patients and 22% of controls (P < .01). For patients, S. aureus colonization on the hands was associated with an atopic HE subtype and HE severity (P = .01 and P < .01, respectively).

Conclusions: Both hand and nasal S. aureus colonization were highly prevalent among HE-patients and may have an impact on the persistence of HE.

Keywords: atopic hand eczema, contact dermatitis, filaggrin, hand eczema, skin barrier function, Staphylococcus aureus.

MeSH terms

  • Adult
  • Case-Control Studies
  • Colony Count, Microbial
  • Dermatitis, Atopic / microbiology*
  • Female
  • Filaggrin Proteins
  • Hand Dermatoses / microbiology*
  • Humans
  • Male
  • Nasal Mucosa / microbiology*
  • Staphylococcal Skin Infections / microbiology*
  • Staphylococcus aureus / isolation & purification*