TY - JOUR
T1 - Hand eczema - prognosis and consequences
T2 - a 7 year follow-up study
AU - Petersen, A. H.
AU - Johansen, J D
AU - Hald, M
N1 - © 2014 British Association of Dermatologists.
PY - 2014/12/1
Y1 - 2014/12/1
N2 - Background Hand eczema is recognized as a long-lasting disease with personal and societal repercussions. Long-term studies are required to generate information on factors contributing to a poor outcome. Objectives The aims of this 7-year follow-up study were to evaluate the clinical course of patients with hand eczema, the occupational consequences and to identify risk factors associated with a poor prognosis. Materials and methods In all, 536 patients with hand eczema participated and were examined by a dermatologist. The clinical severity was assessed at baseline and 7 years later using a self-administrated photographic guide. Additional information was obtained from a questionnaire. Results Based on the photographic guide, 73% experienced a clinical improvement. Notably, 20% had moderate to very severe hand eczema at follow-up. Severe hand eczema or frequent eruptions at baseline and eczema in other body locations during the follow-up period were risk factors of a poor prognosis. The same factors, as well as being a woman, were associated with occupational consequences and low health-related quality of life. Of those with persistent hand eczema only 40% had visited a dermatologist during the follow-up period and 7% had oral treatment. Conclusions The disease had improved 7 years later; nevertheless, many patients continued to have considerable symptoms. Patients with a greater risk of a poor outcome are characterized by frequent eruptions, severe hand eczema and more widespread eczema. It should be questioned if more aggressive therapy and closer medical follow-up would be beneficial. What's already known about this topic? Hand eczema is recognized as a long-lasting disease. However, the clinical severity is highly variable. Hand eczema may lead to negative occupational consequences. What does this study add? In this 7-year follow-up study, the assessment of the clinical severity contributes to knowledge of new aspects of the prognosis of hand eczema. Being a woman is a risk factor for loss of job, problems getting a job and sick leave due to hand eczema.
AB - Background Hand eczema is recognized as a long-lasting disease with personal and societal repercussions. Long-term studies are required to generate information on factors contributing to a poor outcome. Objectives The aims of this 7-year follow-up study were to evaluate the clinical course of patients with hand eczema, the occupational consequences and to identify risk factors associated with a poor prognosis. Materials and methods In all, 536 patients with hand eczema participated and were examined by a dermatologist. The clinical severity was assessed at baseline and 7 years later using a self-administrated photographic guide. Additional information was obtained from a questionnaire. Results Based on the photographic guide, 73% experienced a clinical improvement. Notably, 20% had moderate to very severe hand eczema at follow-up. Severe hand eczema or frequent eruptions at baseline and eczema in other body locations during the follow-up period were risk factors of a poor prognosis. The same factors, as well as being a woman, were associated with occupational consequences and low health-related quality of life. Of those with persistent hand eczema only 40% had visited a dermatologist during the follow-up period and 7% had oral treatment. Conclusions The disease had improved 7 years later; nevertheless, many patients continued to have considerable symptoms. Patients with a greater risk of a poor outcome are characterized by frequent eruptions, severe hand eczema and more widespread eczema. It should be questioned if more aggressive therapy and closer medical follow-up would be beneficial. What's already known about this topic? Hand eczema is recognized as a long-lasting disease. However, the clinical severity is highly variable. Hand eczema may lead to negative occupational consequences. What does this study add? In this 7-year follow-up study, the assessment of the clinical severity contributes to knowledge of new aspects of the prognosis of hand eczema. Being a woman is a risk factor for loss of job, problems getting a job and sick leave due to hand eczema.
U2 - 10.1111/bjd.13371
DO - 10.1111/bjd.13371
M3 - Journal article
C2 - 25156938
SN - 0007-0963
VL - 171
SP - 1428
EP - 1433
JO - British Journal of Dermatology
JF - British Journal of Dermatology
IS - 6
ER -