BACKGROUND: Many of the eczema cases seen by dermatologists involve the hands. The discomfort and embarrassment of hand dermatitis in any of its forms may compromise a patient's quality of life, causing frustrated attempts to identify the cause of the disease and engendering disappointment with treatment failures. METHODS: The authors assessed the severity scores for each patient, personal and familial histories of atopy, coexisting conditions, triggers of irritation, types of treatments, and their success rates. The authors administered a comprehensive survey to 50 consecutive patients presenting with eczematous dermatitis on the ventral aspect of the hands. The authors used a novel hand eczema severity index and a questionnaire that assessed personal and familial histories of atopy as well as coexisting conditions, triggers, and sources of irritation; types of treatments employed; and success rates. Patients were also encouraged to complete a composite quality of life assessment. RESULTS: Results reveal a high frequency of personal and familial atopy, a 58% prevalence of contact allergy, a 67.4% history of hay fever, 25.6% cases of asthma, and a 44% incidence of fungal infection, which was one of the most common coexisting conditions. CONCLUSIONS: Both topical immunomodulators and topical corticosteroid therapy treatments demonstrated an impressive efficacy. An overlap should be considered when clinical symptoms and histological results vacillate between psoriasis and eczema.