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Dermatology and Skin Diseases · Journal article
Journal of Clinical Medicine · August 17, 2026
A consensus or society position rather than new primary data.
This narrative review synthesizes current evidence on occupational contact dermatitis across epidemiology, pathophysiology, diagnosis, prevention and management, emphasizing the self-reinforcing cycle of barrier disruption, microbiome dysbiosis and inflammation. The authors critique the prevention trial base as low-certainty and null in primary and secondary prevention while tertiary-prevention programmes show encouraging but uncontrolled results, and explicitly distinguish established evidence from hypotheses including a proposed trans-kingdom dialogue model.
Narrative review. Literature on occupational contact dermatitis, with particular emphasis on healthcare workers during the COVID-19 pandemic.
Occupational contact dermatitis accounts for roughly 90–95% of occupational dermatoses and predominantly affects the hands Pooled one-year prevalence of self-reported hand eczema in healthcare workers reaches around 27% during COVID-19 era Meta-analytic data link increased risk principally to frequent handwashing and wet work rather than alcohol-based hand rub
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Clinicians should recognize that prevention trials remain low-certainty and largely null, while tertiary-prevention structured programmes show promise but need rigorous evaluation. The synthesis emphasizes the importance of distinguishing established mechanisms from hypotheses and highlights recent therapeutic options such as topical delgocitinib.
A narrative review synthesizing epidemiology, pathophysiology, diagnosis, prevention and management of occupational contact dermatitis, with explicit separation of established evidence from hypothesis, positioned within WHO public health priorities.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should recognize that prevention trials remain low-certainty and largely null, while tertiary-prevention structured programmes show promise but need rigorous evaluation. The synthesis emphasizes the importance of distinguishing established mechanisms from hypotheses and highlights recent therapeutic options such as topical delgocitinib.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background/Objectives: Occupational contact dermatitis (OCD) is the most common work-related skin disease, accounting for roughly 90–95% of occupational dermatoses and falling predominantly on the hands. It is rarely dangerous yet imposes a substantial burden through impaired quality of life, lost productivity, and premature exit from affected trades. The COVID-19 pandemic intensified this burden among healthcare workers, in whom the pooled one-year prevalence of self-reported hand eczema reaches around 27%; meta-analytic data link the increased risk principally to frequent handwashing and wet work rather than to alcohol-based hand rub. Methods: This narrative review, which follows a non-systematic, thematically organised search strategy rather than PRISMA methodology, integrates current evidence on the epidemiology, pathophysiology, diagnosis, prevention, and management of OCD, with particular emphasis on the self-reinforcing cycle linking skin barrier disruption, microbiome dysbiosis, and antimicrobial-peptide dysregulation to inflammation. Results: We critically appraise the prevention evidence, foregrounding the low certainty of the existing trial base and the tension between the randomised trials of primary and secondary prevention, which have been null, and the encouraging but uncontrolled results of structured tertiary-prevention programmes. We summarise recent therapeutic advances, including topical delgocitinib, and situate the field within the World Health Organisation’s 2025 recognition of skin diseases as a global public health priority. Established evidence and hypotheses are kept separate throughout: we additionally advance, explicitly as a conjecture rather than as a demonstrated mechanism, a conceptual trans-kingdom dialogue model in which protease-generated LL-37 fragments may modulate staphylococcal quorum sensing, and each step of that model is labelled according to whether the supporting evidence is direct, extrapolated, or as yet untested. Conclusions: We argue that the prevention failure is less one of biology than of trial design and measurement, and outline the research needed to close the gap.
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