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

BACKGROUND While Staphylococcus aureus (S. aureus) colonisation has been thoroughly studied in atopic dermatitis (AD), where S. aureus is related to flares and considered a trigger factor, S. aureus colonisation in hand eczema (HE) has only been sparsely studied. OBJECTIVES To examine the 1-week prevalence of S. aureus colonisation in HE-patients, and its association with severity, HE-subtype, AD and nasal S. aureus colonisation 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 day 1, 3, 5 and 8. Participants were characterised by demographics, AD, HE-subtype, filaggrin gene mutation status and HE-severity. RESULTS Twenty-seven HE-patients (54%) were colonised with S. aureus on the hands compared to one control (2%) (P<.01). Nasal S. aureus colonisation was found in 72% of patients and 22% of controls (P<.01). For patients, S. aureus colonisation 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 colonisation were highly prevalent among HE-patients and may have an impact on the persistence of HE. This article is protected by copyright. All rights reserved.