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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]

Summary: Background: Wet work is an important risk factor for occupational hand eczema. Objectives: To examine the effect of job change in workers with occupational hand eczema caused by wet work, and to evaluate the dose–response relationship between intensity of wet work and eczema. Method: The study is based on a subgroup (n = 954) from a descriptive, registry‐based study including all participants with occupational hand eczema caused by wet work recognized by the Danish Labour Market Insurance Authority in 2010 and 2011. A follow‐up questionnaire was sent out 4–5 years later (response 58%). Results: Change of profession and being outside the labour market had a positive effect on healing and improvement of hand eczema. Inverse dose–response relationships were found between the amount of time spent with wet hands at work and healing (p = 0.001) and improvement (p < 0.001), and between the frequency of hand washing at work and healing (p = 0.013) and improvement (p < 0.001). Conclusions: Leaving the profession has a positive effect on eczema; however, even minor changes in exposure to wet work were associated with healing and improvement. This information has implications with respect to advice given to patients with occupational hand eczema caused by wet work. [ABSTRACT FROM AUTHOR]

Summary: Background: An inverse relationship between disease severity and health‐related quality of life (HR‐QoL) in patients with hand eczema is well established, but modifying effects of demographic variables have been less well studied. Objective: To identify the influence of metropolitan versus non‐metropolitan residence on the relationship between disease severity and HR‐QoL in patients with occupational hand eczema. Methods: The city of Copenhagen and the rest of Zealand were defined as metropolitan and non‐metropolitan areas, respectively. Participants were 773 persons with occupational hand eczema. A questionnaire on the severity of hand eczema and HR‐QoL was sent to all participants. Results: The odds for reporting moderate to high severity of occupational hand eczema were significantly lower in the metropolitan population than in the non‐metropolitan population [odds ratio (OR): 0.42; 95%CI: 0.23–0.75], whereas low dermatology‐related quality of life was more prevalent in metropolitan than in non‐metropolitan patients (OR: 1.31; 95%CI: 0.83–2.05), indicating that hand eczema had a more pronounced negative effect in metropolitan patients, in spite of less severe eczema. Conclusion: Our data indicate that area of residence has a modifying effect on the relationship between disease severity and HR‐QoL, with a more negative impact on HR‐QoL in metropolitan than in non‐metropolitan areas. This information is important with respect to fully appreciating the burden of occupational hand eczema. [ABSTRACT FROM AUTHOR]

Background Skin disorders accounted for one third of all recognised occupational diseases in Denmark in 2010. Wet work is a risk factor for the development of occupational hand eczema. The consequences of occupational hand eczema include sick leave, loss of job and impaired quality of life. Objectives The aim of the present study was to investigate exposures related to cleaning and the effect of an evidence-based educational intervention on the prevention of hand eczema among hospital cleaners. Patients/Materials/Methods The intervention consisted of a 1 hr course in hand protective behaviour. All full-time cleaners working at Bispebjerg Hospital in January 2013 were invited to participate. The outcome measures were self-reported skin behaviour, exposures, knowledge of skin protection and hand eczema severity index ( HECSI). Results One hundred and five cleaners were invited to participate, of these 86 (82%) were included. At follow-up after 3 months there was a shift towards fewer daily hand washings and hand disinfections ( p < 0.001 and p = 0.001 respectively). The number of correct answers to the knowledge questions rose from 6.3 to 7.3 ( p = 0.006). The mean HECSI score decreased from 2.8 to 1.8 at follow-up ( p = 0.002). Conclusions Data indicates a positive effect of a low-cost on-site educational intervention for hospital cleaners. [ABSTRACT FROM AUTHOR]

Background The incidence of occupational hand eczema is approximately 0.32 per 1,000 person years. The burden of the disease is high, as almost 60% has eczema-related sick leave during the first year after notification, and 15% are excluded from the workforce 12 years after disease onset. New treatments and prevention strategies are needed. Methods/design Trial design: The PREVEX trial is a randomised, parallel-group, superiority trial. Participants: All individuals from the Capital Region of Denmark and Region Zealand with a suspected occupational skin disorder notified to the National Board of Industrial Injuries between June 2012 and December 2013 are invited to participate in the trial. Inclusion criteria are: self-reported hand eczema and informed consent. Exclusion criteria are: age <18 years or >65 years; permanent exclusion from the workforce; inability to understand the Danish language; any serious medical condition; and lack of written informed consent. We plan to randomise 742 participants. Interventions: The experimental intervention is an educational course in skin-protective behaviour and written information about skin care related to their specific occupation. Also, a telephone hotline is available and a subgroup will be offered a work-place visit. The experimental and the control group have access to usual care and treatment. All participants are contacted every eighth week with questions regarding number of days with sick leave or other absence from work. 12 months after randomisation follow-up is completed. Objective: To assesses the effect of an educational course versus treatment as usual in participants with newly notified occupational hand eczema. Randomisation: Participants are centrally randomised according to a computer-generated allocation sequence with a varying block size concealed to investigators. Blinding: It is not possible to blind the participants and investigators, however, data obtained from registers, data entry, statistical analyses, and drawing of conclusions will be blinded. Outcomes: The three co-primary outcomes, assessed at 12 months, are: total number of selfreported days with sick leave; health-related quality of life; and subjective assessment of hand eczema severity. Explorative outcomes are: self-reported eczema-related sick leave, absence from work registered by the DREAM-register and by self-report, risk behaviour, knowledge of skin protection and performance management (self-efficacy; and self-evaluated ability to self-care). Discussion The PREVEX trial will be the first individually randomised trial to investigate the benefits and harms of group-based education in patients with newly notified occupational hand eczema. [ABSTRACT FROM AUTHOR]