Density of the microflora in hand eczema before and after topical treatment with a potent corticosteroid.

Twenty patients with hand eczema were studied with the use of quantitative bacteriologic cultures before and after successful topical treatment with a potent corticosteroid. One sample was taken from the most pronounced eczematous lesion, a second from skin affected with only erythema, and a third from clinically normal skin. Before quantitative bacteriologic analysis, the different species were combined into three main groups: Staphylococcus aureus, other aerobes, and anaerobes. Before treatment, S. aureus colonized the most pronounced eczematous lesion in eighteen of twenty patients and exceeded 10(5) cfu/cm2 in fifteen of twenty patients. The geometric mean count of S. aureus before treatment was significantly higher in eczema (10(4.8) cfu/cm2) than in erythema (10(3.4) cfu/cm2) and significantly higher in erythema than in normal skin (10(1.7) cfu/cm2). The density of other aerobes and anaerobes was similar in the three sampling sites. After treatment, the mean count of S. aureus was significantly reduced at all three sampling sites, and the densities became equal. Treatment did not affect the mean count of other aerobes or anaerobes.