Search

Background: The accuracy of self‐reported hand eczema (HE) is currently unclear, and it is unknown how well self‐reported signs and symptoms of skin lesions that indicate HE correlate with self‐reported HE. Objectives: To correlate self‐reported signs and symptoms of skin lesions on the hands with self‐reported HE, to assess the sensitivity and specificity, and to suggest a definition for HE. Method: Seven hundred ninety‐five (47.8%) of 1663 invited healthcare workers completed a digital questionnaire, and were asked to report if they experienced HE or any of the following skin signs/symptoms in past 11 months: scaling, erythema, fissures, vesicles, dryness, itch, stinging. Results: HE during the past 11 months was reported by 11.9%. Of these, 91.4% reported at least one skin sign versus 32.3% of those without self‐reported HE. The highest sensitivity and specificity were found for erythema (77.4% and 78.2%, respectively) and itch (78.5% and 78.6%, respectively), both separately and combined. The combination of ≥2 signs (erythema, scaling, fissures and vesicles) and itch, reached a sensitivity of 52.7% and specificity of 93.9%. Conclusion: The marked difference between self‐reported HE and signs/symptoms highlights the importance of differentiating between data based on self‐reported HE and signs/symptoms. As a first step towards diagnostic HE criteria, ≥2 signs combined with itch could be considered, but clinical studies are needed to verify the precision. [ABSTRACT FROM AUTHOR]

Background: Hand eczema (HE) is frequently associated with Staphylococcus aureus; however, its role in the pathogenesis of HE is poorly understood.Objective: To investigate the temporal variation in S aureus subtypes, ie, clonal complex (CC) types, on the hands and relate it to S aureus colonization in the nose and severity in a cohort of HE patients.Methods: S aureus from the hands and nose of 50 adult HE patients and 50 controls was prospectively identified at 5 visits over 3 weeks.Results: S aureus was identified on the hands of 23 (46%) patients at 2 or more visits and on the hands of 1 control once. Of the HE patients with S aureus colonization, 78% had the same S aureus CC type over time. Twenty-one patients had the same S aureus CC type on the hands and in the nose. Persistent colonization was strongly related to an increased disease severity.Limitations: A relatively small S aureus culture-positive population.Conclusion: The temporal stability of S aureus CC type and high occurrence of the identical subtypes on the hands and in the nose imply that S aureus colonization in patients with HE is of a more permanent nature. Taken together with the finding that persistent colonization and HE severity are clearly related, our results indicate that S aureus may contribute to the perpetuating course of HE. [ABSTRACT FROM AUTHOR]

Background: Hand eczema (HE) is common in health care workers (HCWs). During the last decade, new recommendations have supported increased use of alcohol‐based hand rub (ABHR) to partially replace hand washings to lower the prevalence of HE. However, newer data on this recommendation is lacking. Objectives: To assess current 1‐year prevalence of HE in HCWs, to investigate exposure, and the extent of subjective discomfort to hand washings and ABHR. Methods: A digital questionnaire was sent to 4876 HCWs from April to May 2020. Results: Of 2125 respondents (1779 women, 346 men), 14.7% reported HE within the last year. In total, 9.1% reported >20 hand washings per shift and 76.0% reported ABHR use >20 times per shift. HE was significantly associated with hand washings (adjusted odds ratio [OR] 1.73 [95% confidence interval [CI] 1.26‐2.36]) and glove use on wet skin (adjusted OR 1.99 [95% CI 1.27‐3.12]). Subjective discomfort to ABHR was reported significantly more often than to hand washings (P <.001) and significantly more often in HCWs with HE than in those without HE (P <.001). Conclusions: The current 1‐year HE prevalence in HCWs of 14.7% was lower than in previously reported Scandinavian data. HE was related to frequent hand washings, as previously reported, and to glove use on wet skin, which is a possible risk factor for HE that should be further explored. [ABSTRACT FROM AUTHOR]

Hand eczema is frequently colonized with Staphylococcus aureus. Some patients with hand eczema wear occlusive gloves regularly; however, the effect of this on the density of S. aureus is unexplored. The aim of this study is to examine the effect of occlusive gloves on the density of S. aureus sampled from the hands of patients with hand eczema. In an experimental set-up, patients with moderate-to-severe hand eczema wore an occlusive glove on one hand for 4 h with a 30-min break. Bacterial swabs were collected from the most severe eczema lesion on the hand before and immediately after glove exposure. S. aureus colony-forming units were counted and log-transformations used for comparison of before- and after-values. Among 30 patients, 19 (63%) were colonized with S. aureus. After glove occlusion S. aureus colony-forming units increased by a factor of 1.72 (p < 0.01). In conclusion, the density of sampled S. aureus on eczematous skin after prolonged wearing of occlusive gloves is greatly increased. [ABSTRACT FROM AUTHOR]

Background: Concerns have been raised that a chronic course of hand eczema (HE) could be fostered by a lack of efficient treatment at an early stage. Objectives: First, to assess the prevalence of systemic treatment in patients with chronic occupational HE (OHE) and relate this to demographic data, HE severity, and atopic dermatitis (AD). Second, to explore the use of complementary and alternative medicine (CAM) in the same population. Methods: Baseline data were obtained from a registry‐based study including patients with recognized OHE in a 2‐year period in Denmark, comprising a total of 2703 workers. A follow‐up questionnaire after 4 to 5 years included questions on disease severity and treatments. Results: A total of 1565 participants responded to the questionnaire, and of these 1203 had ongoing HE at follow‐up and were included in the study. In total, 10.0% had received systemic therapy, whereas this share was 13.3% in those with self‐reported moderate‐to‐severe HE. Age >35 years, previous or current AD, and severe eczema were factors related to use of systemic treatment. Use of CAM was reported by 6.2% of the study population. Conclusions: We suggest that chronicity of HE may be perpetuated by the lack of efficient treatment. [ABSTRACT FROM AUTHOR]

Background: Several studies have assessed the effect of patient education regarding hand eczema (HE) severity and quality of life. Few studies, however, have evaluated patients' knowledge. Objectives: To examine knowledge of skin protection in HE patients following a guided talk, and to identify variables associated with knowledge. Methods: HE patients referred to the outpatient dermatological clinic, Bispebjerg Hospital, between January 2013 and July 2014 were offered a guided talk on HE prevention. HE severity and the Dermatology Life Quality Index (DLQI) score were assessed. A questionnaire comprising 10 questions about skin protection was sent 1 to 2.5 years later. Results: One hundred and twenty patients responded to the questionnaire (response 53.5%). The mean percentage of correct answers was 74.7%. Sixty per cent responded correctly to at least eight questions. Male sex, older age and education for >5 years were associated with a low level of knowledge. Education for 3 to 4 years (P = 0.045) was associated with a higher level of knowledge. No significant impact of previous/current atopic dermatitis, HE severity or previous information on skin protection was found with respect to level of knowledge. Conclusions: Females and patients with education for 3 to 4 years showed the highest level of knowledge, whereas males, older patients and patients with education for >5 years should be brought more into focus in skin protection programmes. [ABSTRACT FROM AUTHOR]

Background: Sickness absence in hand eczema patients has been associated with stress rather than disease severity, indicating that personal aspects regarding hand eczema should be investigated further. Objectives: To examine whether patient education vs treatment as usual can influence behaviour and knowledge regarding skin protection and care, as well as personal resources, in patients with occupational hand eczema. Methods: PREVEX is an individually randomized clinical trial investigating the 1‐year effects of a simple, low‐cost group‐counselling programme vs treatment as usual for patients with notified occupational hand eczema. Exploratory outcomes were behaviour, knowledge, self‐efficacy, and self‐evaluated skin care ability. Results: In total, 1668 patients with notified occupational skin disease were invited to participate, of whom 769 were randomized and 756 were analysed: intervention group (n = 376) vs control group (n = 380). Behaviour was improved and the knowledge score increased in the intervention group as compared with the control group (respectively: estimate 0.08; 95%CI: 0.02‐0.19; P = .01; and estimate 0.49; 95%CI: 0.28‐0.70; P < .001). Self‐efficacy was lower in the intervention group as compared with the control group (estimate −0.78; 95%CI: −1.25 to −0.30; P = .001). No difference was found regarding skin care abilities. Conclusions: The intervention had a positive influence on 1‐year behaviour and knowledge, but was insufficient to result in long‐term positive changes in personal resources regarding dealing with hand eczema. [ABSTRACT FROM AUTHOR]

Background It has been suggested that lifestyle factors such as smoking, overweight and stress may influence the prevalence and severity of hand eczema. Objectives To investigate the association between lifestyle factors and hand eczema severity in a cohort of patients with work-related hand eczema. Methods Individuals with work-related hand eczema notified in the period between June 2012 and November 2013 were included in this questionnaire-based cross-sectional study. Participants responded to a questionnaire including questions on lifestyle factors, as well as a photographic guide for assessment of severity of hand eczema and questions on quality of life. Results A total of 773 individuals (546 women and 227 men) responded to the questionnaire and were included in the study. A strong association was found between tobacco smoking and hand eczema severity ( p = 0.003), whereas no significant association was found for body weight and stress. Other factors linked to severe eczema were male sex and older age ( p = 0.04 and p = 0.01, respectively), and wet work ( p = 0.08). Conclusion The data from the present study strongly support an association between smoking and hand eczema severity. However, owing to the cross-sectional design of the study, no conclusion on causation can be drawn. [ABSTRACT FROM AUTHOR]

Background The aim of the present study was to examine the knowledge of skin care and treatment of hand eczema ( HE) in a sample of patients with newly reported occupational HE. Materials and methods A questionnaire consisting of 13 questions about knowledge of skin care and treatment of HE was sent to all patients with occupational HE reported to the National Board of Industrial Injuries in the period 1 January 2010 to 31 March 2010. Results Three hundred and seventy individuals, 269 females and 101 males, with a mean age of 39.9 years, responded to the questionnaire (response rate of 73%). The overall percentage of correct answers was 73%. Variables significantly influencing the level of knowledge were sex and age, with a need for more information in males and in patients above the age of 50 years. No significant influence of level of education, eczema activity, previous information about HE, previous or current atopic eczema or dermatology life quality index ( DLQI) was found. Conclusion There is still potential for improvement of the level of knowledge among patients with occupational HE. Special attention should be paid to males and patients above the age of 50 years. [ABSTRACT FROM AUTHOR]