Main Clinical Features of Patients with Irritant and Allergic Contact Dermatitis on the Hands in Correlation with Skin CD44 Expression: A Prospective Study.

Contact dermatitis (CD), including its irritant (ICD) and allergic (ACD) types, is a complex, often chronic and therapy-resistant disease that significantly affects patient quality of life and healthcare systems. Objective of this study was to examine the main clinical features of patients with ICD and ACD on the hands through follow-up in correlation with baseline skin CD44 expression. Our prospective study involved 100 patients with hand CD (50 with ACD; 50 with ICD) who initially underwent biopsies of skin lesions with pathohistology, patch tests to contact allergens, and immunohistochemistry for lesional CD44 expression. The patients were subsequently followed-up on for a year, after which they filled out a questionnaire designed by the authors examining disease severity and disturbances/issues. Patients with ACD had significantly higher disease severity than those with ICD (P<0.001), with more frequent systemic corticosteroid treatments (P=0.026) and greater areas of affected skin (P=0.006), exposure to allergens (P<0.001), and impairment of everyday activities (P=0.001). No correlation between ICD/ACD clinical features and initial lesional CD44 expression was observed. Due to the commonly severe course of CD, especially ACD, more research and prevention are needed, including the analysis of the role of CD44 in connection with other cell markers.