Forty-nine studies met the inclusion criteria: 28 studies (n=760) were considered to be good or fair quality and 21 studies were considered to be poor quality.
Prevention of ICD.
Several good-quality studies found that certain barrier creams (2 studies), moisturising creams (2 studies) and fabric softeners (1 study) were effective in the prevention of ICD. One good-quality study found that barrier cream was worse than a vehicle control. Several fair-quality studies found that certain moisturisers (4 studies), barrier creams (2 studies) and the use of cotton glove liners (1 study) were effective in the short-term prevention of ICD. Educational interventions (2 studies) provided less promising evidence.
Treatment of ICD.
Four studies (3 good quality and 1 fair quality) found that lipid-rich moisturisers were effective in the short-term treatment of ICD. One fair-quality study found application of moisturiser to dry hands prior to donning gloves was associated with less visual dryness compared with the control, but no difference in erythema. None of the included studies reported on quality of life or return to work.
Prevention of ACD.
No good-quality studies were identified that evaluated the prevention of ACD. Five fair-quality studies evaluated different interventions, and found evidence to support the use of topical skin protectant and quaternium-18-bentonite for rhus dermatitis, and diethylenetriamine pentaacetic acid for nickel, chrome and copper dermatitis. Evidence from fair-quality studies suggested pentoxifylline was not effective.
Treatment of ACD.
Four good-quality studies and one fair-quality study evaluated various moderate-to-potent steroids and showed them to be effective in the treatment of ACD. No study evaluated quality of life or return to work.
Addition details on the quality assessment and results of individual studies can be found in the online supplement available on the Journal of the American Academy of Dermatology website (accessed July 2007; note, a subscription is required to access this information).