This study aimed to explore the role of microbial ecosystems on the skin in the development of hand eczema (HE). In this retrospective cohort study of 178 patients with HE, bacterial swabs were collected from affected skin for culturing. The study assessed the association between bacterial colonization, disease severity, symptoms, and etiology. The findings revealed that most HE patients had positive tests for Staphylococcus aureus (S. aureus) and skin flora. S. aureus was identified in 77.5% of patients, while skin flora was present in 78% of cases. Significantly, the presence of S. aureus was linked to an increased risk of HE severity, with an odds ratio (OR) of 3.71, suggesting that S. aureus colonization was a significant risk factor for severe HE. Conversely, skin flora was associated with a protective effect, with an OR of 0.27, indicating a lower risk of extreme HE. Furthermore, the study found that S. aureus colonization was linked to atopic HE etiology and acute HE symptoms such as blisters, erosions, and crusts. In conclusion, the research highlights that S. aureus is the primary bacterial colonization in HE patients and is closely associated with disease severity, acute symptoms, and atopic etiology. The presence of skin flora might confer a protective effect on the severity of HE, potentially leading to the development of novel treatment strategies.

Poster ID 336, European Academy of Dermatology and Venereology, Berlin 11-14 October 2023