Patterns of Pediatric Chronic Hand Eczema: A Systematic Review With Focus on Causes and Management
Bibliographic record
Abstract
Chronic hand eczema (CHE) is commonly seen in adults and often in the context of occupational exposures. Recently, there has been a growing number of cases reported among children. We conducted a systematic review using the PRISMA framework to identify cases of pediatric CHE. Search terms included "eczema," "dermatitis," "pompholyx," "dyshidrosis," "contact allergy," and "pulpitis." Case reports of patients aged <18 years old without an alternate/confounding diagnosis were included. 62 cases were included with a mean age of 10.9 years. In the patients with reported data, 61% (28/46) had a history of atopy and 38% (14/37) reported lesions were present for >1 year. The most common cause was allergic-contact dermatitis (71%) with the bilateral hands affected (87%). A total of 35 unique triggers were identified, with the top 5 being homemade slime (n = 28), store-bought slime (n = 8), outdoor plants (n = 4), UV-curing methacrylate nail polish (n = 4), and sporting gloves (n = 4). Patch testing was performed in 87% (54/62) of patients, of which 96% (52/54) tested positive to 1+ allergens. Positive reactions to methylchloroisothiazolinone and/or methylisothiazolinone (MCI/MI) were among the most common. In 53% (33/62) of patients, removal of the trigger resulted in resolution. Patterns of CHE triggers in pediatric patients differ from adults, and workup should include a detailed history of leisure-time and school activities. MCI/MI was the most common culprit, and trends involving children making slime has led to an increase in prolonged/repeated exposure. Awareness of potential causes ensures early identification, patch testing, prompt removal of trigger, and appropriate management.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.014 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.004 |
| Bibliometrics | 0.010 | 0.012 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".