Is Dermatitis Palmaris Sicca an Irritant Contact Dermatitis?

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BackgroundDermatitis palmaris sicca (DPS) is a common dry-fissured palmar dermatitis in Asian women. It may be an irritant contact dermatitis, but the immunophenotype of the cells in its infiltrate is unknown.ObjectiveThe aim of this study was to evaluate the role of inflammatory cells in the pathogenesis of DPS.MethodsPatch testing was done in 68 patients with DPS, 87 subjects with hand eczema, and 31 healthy subjects. Immunophenotyping of cutaneous inflammatory cells was performed in 8 patients with DPS, 10 subjects with hand eczema, and 8 healthy individuals.ResultsPositive patch rates were higher in patients with DPS and those with hand eczema compared with healthy controls, but strong positive (++ or +++) reactions in DPS were fewer compared with hand eczema. Density of CD3+, CD4+, CD8+, and CD68+ cells in skin lesions of DPS and hand eczema was significantly higher than that in normal skin. Sparse CD20+ cells were present only in hand eczema. Compared with hand eczema, the number of CD3+, CD8+, CD68+, and dermal CD1a+ cells decreased, but epidermal CD1a+ cells and CD4/CD8 ratio increased in DPS.ConclusionsThe absolute lack of CD20+ cells and relative scarcity of dermal CD8+ and CD1a+ cells in skin lesions might be insufficient to induce contact hypersensitivity, so DPS may be an irritant but not allergic contact dermatitis.

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