Effectiveness of Emollient Topical Therapy on Hand Dermatitis Events

e-ISSN 2774-2318 p-ISSN 2407-0505 Berkala Ilmiah Kedokteran dan Kesehatan Literature Reviews Berkala Ilmiah Kedokteran dan Kesehatan Journal Page: https://jurnal.unimus.ac.id/index.php/APKKM Effectiveness of Emollient Topical Therapy on Hand Dermatitis Rahma Pranesti1, Em Sutrisna2, NidaFaradisa3, Ratih Pramuningtyas4 1,2,3,4) Medical Faculty of Universitas Muhammadiyah Surakarta, Surakarta, Central Java, Indonesia Article Info Article history: Received 30 March 2021 Revised 11 October 2023 Accepted 02 January 2024 Available online 02 February 2024 Keywords: Hand dermatitis; hand eczema; emollients; moisturizer Correspondence: How to cite this article: Rahma Pranesti, Em Sutrisna, NidaFaradisa, Ratih Pramuningtyas. Effectiveness of Emollient Topical Therapy on Hand Dermatitis. MAGNA MEDIKA Berk Ilm Kedokt dan Kesehat. 2024;11(1):60-70 Abstract Background: Clinically, hand dermatitis manifests as either irritant contact dermatitis (ICD) or allergy contact dermatitis (ACD). Patients with hand dermatitis typically use emollients to reduce transepidermal water loss (TEWL). Objective: This investigation aims to evaluate the efficacy of emollient topical therapy on hand dermatitis. Methods: The study's design was based on a literature review, and the research samples were obtained through online searches on Google Scholar, PubMed, and ScienceDirect. Results: 495 items were subsequently excluded based on the restriction criteria. We obtained eight research articles for evaluation. Hand Eczema Severity Index (HECSI), TEWL, Dermatology Life Quality Index (DLQI), Health-related quality of life (HRQoL), Modified Total Lesion Symptom Score (mTLSS), Investigator Global Assessment (IGA), and Visual analog score (VAS) were used to measure hand dermatitis, and there was a significant increase in these measurements for emollients. In the conclusion of the eight articles, six stated that they were significant, and two stated that emollients were effectively used as topical therapy. Conclusion: Emollients typically act on the epidermis, particularly the stratum corneum, which can reduce TEWL so that antigen penetration and inflammation spread are not facilitated. 2024 MAGNA MEDIKA: Berkala Ilmiah Kedokteran dan Kesehatan with CC BY NC SA license Rahma Pranesti, Em Sutrisna, NidaFaradisa, Ratih Pramuningtyas. Effectiveness of Emollient Topical Therapy on Hand Dermatitis 60 doi: 10.26714/magnamed.11.1.2024.60-70 11 (1) February 2024 e-ISSN INTRODUCTION Hand dermatitis is defined as skin inflammation that manifests clinically as irritant contact dermatitis or allergic contact dermatitis. Hand dermatitis is a primary occupational concern, accounting for over 80% of all dermatitis. In a nursing study in the United States, around 33% of the participants had hand dermatitis. Hand dermatitis or eczema has a variety of etiologies, including atopic endogenous disorders and exogenous causes such as irritating contact dermatitis and allergic contact dermatitis 1. Clinical symptoms might range from vesicular and erosive to hyperkeratotic and desquamative. Hand dermatitis can be acute, recurring, or chronic as time passes 2. Chronic hand dermatitis drastically disrupts everyday life by causing discomfort and shame, as well as having a significant economic impact on nurses in the United States. According to research in Canada, the annual cost of hand dermatitis ranges between CAN $390 to $737 million 3. The prevalence of hand dermatitis varies depending on geography. In Indonesia, the prevalence of contact dermatitis varies widely. According to PERDOSKI 2009, about 90% of occupational skin diseases are contact dermatitis, with the remaining 92.5% being skin infections and the remaining 2.1% being other causes 4. The prevalence of hand dermatitis was 11% in a Swedish epidemiological survey of 20,000 adults between the ages of 20 and 65 last year, as well as 20-35% of all hand-attacking dermatitis. Women are afflicted more frequently than males (2:1), most likely because of increased exposure to wet work and home pollutants. The most common kinds of hand dermatitis in the Meding study were irritating contact dermatitis (35%), atopic hand derma-titis Rahma Pranesti, Em Sutrisna, NidaFaradisa, Ratih Pramuningtyas. Effectiveness of Emollient Topical Therapy on Hand Dermatitis 2774-2318 p-ISSN 2407-0505 Berkala Ilmiah Kedokteran dan Kesehatan (22%), and allergic contact dermatitis (19%)5. According to researchers recently described in a review paper, risk factors for dermatitis include gender, particularly women, contact allergies, atopic dermatitis, and damp work. The most critical risk factor for hand dermatitis has been identified as atopic dermatitis. Hand dermatitis is connected with female sex, childhood dermatitis, and early age in the general population 6. Excessive hand washing due to the COVID-19 pandemic (Corona Virus Disease) can increase the frequency of cases of dermatitis 7. Hand hygiene, physical distance, coughing and sneezing ethics, and wearing facial masks are among the most significant and highly recommended preventive strategies. Due to regular hand washing, there have been reports of increased dermatological consultations for hand dermatitis in health workers and the general population. Because of the prevalence of hand dermatitis, only about 22.1% of the population uses emulsifiers after washing their hands. Higher washing frequencies cause imbalances that cause an increased risk of hand dermatitis. Thus, the American Contact Dermatitis Society (ACDS) anticipates increased hand dermatitis, particularly allergic contact dermatitis, and irritating contact dermatitis, as a result of more frequent washing of hands by using emollients after hand washing 8. Emolien or moisturizer is very effective in restoring hydration and repairing the corneal stratum. Using emollients can provide protection and strengthen the protective function of the skin. Emolien works mainly by increasing water levels in the skin, especially in the outer corneal stratum. The emollient acts as a physical barrier to lower the Trans Epidermal Water 61 doi: 10.26714/magnamed.11.1.2024.60-70 11 (1) February 2024 e-ISSN Loss (TEWL), which provides water content recharge in the corneum stratum, so it requires the use of emollient after washing hands to reduce the increase in dermatitis due to repeated washing of hands in response to COVID-19 8. The effectiveness of various types of emollients has been studied by other authors; according to Corazza, 2014, emollients have been shown to protect against detergents such as sodium lauryl sulfate (SLS) and hydrophilic substances such as NaOH on wet work, but in a study written in article 9. Stearate acid contained in the emollient, when reacting with NaOH, can increase irritation and then cause irritant contact dermatitis 9. Because there are contradictory results, the author would like to conduct additional research on the effectiveness of emollient (...truncated)