Sustainability is becoming increasingly important in healthcare and has moved into focus at various levels. This article aims to provide an overview of guiding principles, concepts, and target systems of sustainability and to transfer these to occupational dermatology. Current and future starting points are outlined for various levels, e.g., politics, research, industry, and patient care, in order to link sustainability and occupational dermatology in a structured and systematic way and to transform the structures of patient care in occupational dermatology care towards sustainability. Using the specific example of protective gloves, which is a pivotal personal protective measure to prevent work-related hand eczema, starting points, potentials, and challenges are analyzed and specific possibilities and perspectives for more ecologically sustainable action are presented.
UNASSIGNED: Nachhaltigkeit gewinnt in der Gesundheitsversorgung zunehmend an Bedeutung und ist auf verschiedensten Ebenen als Ziel in den Fokus gerückt. Ziel dieses Beitrags ist es, einen Überblick über Leitbilder, Konzepte und Zielsysteme von Nachhaltigkeit zu geben und diese auf die Berufsdermatologie zu transferieren. Für verschiedene Ebenen, z. B. Politik, Forschung, Industrie sowie die Patientenversorgung, werden gegenwärtige und zukünftige Ansatzpunkte skizziert, um Nachhaltigkeit und Berufsdermatologie strukturiert und systematisch zu verknüpfen und die berufsdermatologische Versorgungslandschaft zu transformieren. Am konkreten Beispiel der Verwendung von Schutzhandschuhen – eine der zentralen personenbezogenen Schutzmaßnahmen in der berufsdermatologischen Verhaltensprävention – werden exemplarisch Ansatzpunkte, Potenziale und Herausforderungen analysiert sowie konkrete Möglichkeiten und Perspektiven für ökologisch nachhaltigeres Handeln aufgezeigt.

BACKGROUND: Comfort gloves are used in the management of hand dermatoses.
OBJECTIVE: To compare the acceptance and tolerability of comfort gloves made of different materials in patients with hand dermatoses and their effects on skin lesions.
METHODS: In a prospective multicenter study, 284 patients with hand dermatoses were invited to wear either a cotton glove (COT) or a semipermeable Sympatex glove underneath a cotton glove (SYM/COT) for two subsequent phases of 19 consecutive nights each. A total of 88 controls were asked not to wear any comfort gloves overnight. The severity of skin lesions over time was examined. Questionnaires were used to assess health-related quality of life (HRQoL) and acceptance and tolerability of the gloves.
RESULTS: The hand dermatoses improved in all groups. No substantial intergroup differences regarding severity and HRQoL were observed. SYM/COT received better ratings regarding climate conditions and tactility while COT showed superiority in fit, wearing comfort, and practicality.
CONCLUSIONS: We confirmed that SYM/COT and COT are well tolerated and accepted suggesting that SYM/COT is a good alternative for COT as comfort gloves in patients with hand dermatoses. Individual requirements, needs, and preferences may direct the material choice.

Hand eczema is a common allergic disease characterized by a chronic relapsing course with a 15% lifetime prevalence. Human immunodeficiency virus-infected individuals have a higher risk of Staphylococcus aureus infection which is associated with the severity of hand eczema. Incidences of allergic diseases including hand eczema and chronic itch are higher in patients with human immunodeficiency virus. Pruritus is one of the most common symptoms in hand eczema, sometimes intractable pruritus provokes repeated scratching, picking, disfigurement, and can even worsen the lesion. Currently, there is no ideal treatment for hand eczema, the treatment of hand eczema in human immunodeficiency virus patients is even more difficult. Here, we present a case of recurrent and therapy-resistant hand eczema patients combined with Staphylococcus aureus infection, human immunodeficiency virus infection was better improved by being treated with topical ozone therapy.

Hand eczema (HE) is a common condition seen in medical facilities, particularly during the COVID-19 pandemic. The effects of vitamin D on skin inflammation are diverse. The purpose of this study is to examine the relationship between vitamin D levels in healthcare workers as determined by serum 25(OH)D and the severity of HE. In Indonesia, between September and October of 2022, a cross-sectional design was employed for this analytical descriptive study. The hand eczema severity index was used to determine the severity of HE. Out of the 44 healthcare workers who had HE, the findings indicated that 29 had mild HE, 11 had moderate HE, and 4 had severe HE. Subjects with mild, moderate, and severe HE had mean serum 25(OH)D levels of 17.85 ng/mL, 16.45 ng/mL, and 17.87 ng/mL, respectively, falling into the vitamin D deficiency category. Serum 25(OH)D levels and the severity of HE did not significantly correlate (r=-0.056; p=0.359). Serum 25(OH)D levels did not significantly differ between subjects with mild, moderate, and severe HE. The degree of HE was not negatively correlated with serum 25(OH)D levels.

BACKGROUND: Twin studies revealed that genetic effects play a role in hand eczema (HE), but the responsible genetic factors are unknown.
OBJECTIVE: To identify and characterise genetic loci associated with HE and to provide insight into the genetic overlap between HE and atopic dermatitis (AD).
METHODS: We used questionnaire-derived and genotype data from the European population-based Lifelines cohort and biobank. We performed a discovery genome-wide association study (GWAS) of HE (2879 cases and 16 249 controls) and of AD (1706 cases and 17 190 controls). We replicated our findings in an independent Lifelines sample for HE (1188 cases and 6431 controls) and AD (757 cases and 6747 controls). We conducted several post-GWAS analyses and performed genetic correlation analyses between our HE results and independent AD data.
RESULTS: The two-step GWAS of HE, regardless of adjusting for AD, identified one independent locus 20q13.33, likely driven by a number of causal single-nucleotide polymorphisms. For the AD GWAS, we replicated a known stop-gained rs61816761 at locus 1q21.3 (FLG, FLGAS1). We found a strong genetic correlation (p < 0.01) between HE and AD (rg = 0.65), regardless of adjusting for AD (rg = 0.63).
CONCLUSIONS: Locus 20q13.33 is associated with HE, and there is a large genetic overlap between HE and AD.

Artificial intelligence (AI) is revolutionizing dermatology by enhancing diagnostic accuracy and offering personalized treatment recommendations based on individual patient characteristics and medical history. This month\'s editorial discusses the transformative role of AI in dermatology, emphasizing its potential to enhance diagnostic accuracy, personalize treatment, and improve healthcare delivery efficiency. It highlights three manuscripts addressing AI\'s applications in dermatopathology, climate change-related skin disorders, and health care for undocumented immigrants. Ethical concerns, such as AI transparency and overdiagnosis, are also noted. Additionally, new treatments for atopic dermatitis (AD) are examined. We specifically recommend two recent reports on the efficacy of dupilumab in pediatric AD and refractory hand eczema (HE), demonstrating advancements in dermatological therapy for treatment-resistant conditions.

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Vesicular hand eczema (VHE), a clinical subtype of hand eczema (HE), showed limited responsiveness to alitretinoin, the only approved systemic treatment for severe chronic HE. This emphasizes the need for alternative treatment approaches. Therefore, our study aimed to identify drug repurposing opportunities for VHE using transcriptomics and genomics data. We constructed a gene network by combining 52 differentially expressed genes (DEGs) from a VHE transcriptomics study with 3 quantitative trait locus (QTL) genes associated with HE. Through network analysis, clustering, and functional enrichment analyses, we investigated the underlying biological mechanisms of this network. Next, we leveraged drug-gene interactions and retrieved pharmaco-transcriptomics data from the DrugBank database to identify drug repurposing opportunities for (V)HE. We developed a drug ranking system, primarily based on efficacy, safety, and practical and pricing factors, to select the most promising drug repurposing candidates. Our results revealed that the (V)HE network comprised 78 genes that yielded several biological pathways underlying the disease. The drug-gene interaction search together with pharmaco-transcriptomics lookups revealed 123 unique drug repurposing opportunities. Based on our drug ranking system, our study identified the most promising drug repurposing opportunities (e.g., vitamin D analogues, retinoids, and immunomodulating drugs) that might be effective in treating (V)HE.