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Background Objectives Methods Results Conclusions Studies on wet work and hand eczema (HE) frequently rely solely on self‐reports regarding wet work.To assess the association between wet work and moderate‐to‐very‐severe HE, within the Dutch general population, by using a (sex‐specific) job exposure matrix (JEM).Within the Lifelines Cohort Study, participants with self‐reported moderate‐to‐very‐severe HE at worst in the past year were linked to data from the Danish (sex‐specific) wet work JEM, a tool that links occupations with wet work indices (including duration and probability of glove use, wet hands and total wet work for at least 2 and 4 h/working day).In total, 56 978 (41.9%) participants were included. The multivariate binary logistic regression analyses showed significant associations between all facets of wet work and moderate‐to‐very‐severe HE. When using the sex‐specific JEM, significant associations were found in females, but not in males.This study is the first to use a wet work‐specific JEM in a general population sample, and found positive associations between wet work and HE. The sex‐specific findings should be interpreted with caution, due to limitations inherent in using a JEM, and should be further explored with observational studies, with a focus on duration, frequency, and exposure type. [ABSTRACT FROM AUTHOR]

Background: Twin studies revealed that genetic effects play a role in hand eczema (HE), but the responsible genetic factors are unknown. Objectives: To identify and characterise genetic loci associated with HE and to provide insight into the genetic overlap between HE and atopic dermatitis (AD). Methods: We used questionnaire‐derived and genotype data from the European population‐based Lifelines cohort and biobank. We performed a discovery genome‐wide association study (GWAS) of HE (2879 cases and 16 249 controls) and of AD (1706 cases and 17 190 controls). We replicated our findings in an independent Lifelines sample for HE (1188 cases and 6431 controls) and AD (757 cases and 6747 controls). We conducted several post‐GWAS analyses and performed genetic correlation analyses between our HE results and independent AD data. Results: The two‐step GWAS of HE, regardless of adjusting for AD, identified one independent locus 20q13.33, likely driven by a number of causal single‐nucleotide polymorphisms. For the AD GWAS, we replicated a known stop‐gained rs61816761 at locus 1q21.3 (FLG, FLGAS1). We found a strong genetic correlation (p < 0.01) between HE and AD (rg = 0.65), regardless of adjusting for AD (rg = 0.63). Conclusions: Locus 20q13.33 is associated with HE, and there is a large genetic overlap between HE and AD. [ABSTRACT FROM AUTHOR]

Background: To date, hand eczema (HE)‐related presenteeism has never been assessed within the general population, and general population‐based studies on HE‐related sickness absence are limited. Objectives: To assess the prevalence of HE‐related presenteeism and sickness absence, and factors associated with HE‐related presenteeism, within the Dutch general population. Methods: Within the Lifelines Cohort Study, participants with HE in the last year (aged 18–65 in 2020), were identified by a questionnaire including questions regarding HE‐related presenteeism and sickness absence. Socio‐demographic factors were collected from 2006 to 2020. Results: Out of the 3.703 included participants with HE, 2.7% (n = 100) reported HE‐related presenteeism, with 19.8% (n = 57) among those with severe‐to‐very‐severe HE. HE‐related sickness absence was reported by 0.5% (n = 20) and 5.9% (n = 17), respectively. Logistic regression analyses, adjusted for age and sex, showed negative associations between HE‐related presenteeism and higher educational attainment, higher income (>€2500) and higher occupational skill level, and positive associations for high‐risk occupations, chronic HE, moderate and severe‐to‐very‐severe HE (compared to almost clear), atopic dermatitis and occupational wet exposure. Conclusions: A high prevalence of HE‐related presenteeism was found among participants with severe‐to‐very‐severe HE. Future studies should focus on longitudinal associations with the clinical course of HE, as HE‐related presenteeism might aggravate symptoms of HE. [ABSTRACT FROM AUTHOR]

Background: Real‐world data on the effectiveness of upadacitinib on atopic dermatitis (AD), hand eczema (HE) and HE in the context of AD are limited. Objectives: To evaluate the effectiveness and safety of upadacitinib on AD and on HE in patients with AD. Methods: This prospective observational cohort study includes clinical outcomes: Eczema Area and Severity Index (EASI), Investigator's Global Assessment (IGA), Hand Eczema Severity Index (HECSI), Photographic guide; and PROMs: average pruritus and pain Numeric Rating Scale (NRS) score of the past week, Patient‐Oriented Eczema Measure (POEM), Patient‐Oriented Eczema, Dermatology Life Quality Index (DLQI), Atopic Dermatitis Control Tool (ADCT), Patient Global Assessment of Disease (PGAD), Quality Of Life Hand Eczema Questionnaire (QOLHEQ) at baseline, Week 4, and Week 16 of upadacitinib‐treated patients. Adverse events were monitored during each visit. Results: Thirty‐eight patients were included, of which 32 patients had HE. At Week 16, EASI‐75 was achieved by 50.0%. Absolute cutoff score NRS‐pruritus ≤4 was reached by 62.5%, POEM ≤7 by 37.5%, DLQI ≤5 by 59.4%, ADCT <7 by 68.8%, and PGAD rating of at least 'good' by 53.1%. HECSI‐75 was achieved by 59.3% and (almost) clear on the Photographic guide by 74.1%. The minimally important change in QOLHEQ was achieved by 57.9%. Sub‐analysis in patients with concomitant irritant contact dermatitis showed no differences. Safety analysis showed no new findings compared to clinical trials. Conclusions: Upadacitinib can be an effective treatment for patients with AD and concomitant HE in daily practice. Future studies should focus on the effectiveness of upadacitinib on chronic HE, especially on the different etiological subtypes of HE, including HE in non‐atopic individuals. [ABSTRACT FROM AUTHOR]

Evidence regarding the association between lifestyle factors and hand eczema is limited.To extensively investigate the association between lifestyle factors (smoking, alcohol consumption, stress, physical activity, body mass index, diet, and sleep) and the prevalence, incidence, subtype, severity, and prognosis of hand eczema, a systematic review and meta‐analysis were conducted in accordance with the Meta‐analysis Of Observational Studies in Epidemiology consensus statement. MEDLINE, Embase, and Web of Science were searched up to October 2021. The (modified) Newcastle‐Ottawa Scale was used to judge risk of bias. Quality of the evidence was rated using the Grades of Recommendation, Assessment, Development and Evaluation approach. Eligibility and quality were blindly assessed by two independent investigators; disagreements were resolved by a third investigator. Data were pooled using a random‐effects model, and when insufficient for a meta‐analysis, evidence was narratively summarized. Fifty‐five studies were included. The meta‐analysis (17 studies) found very low quality evidence that smoking is associated with a higher prevalence of hand eczema (odds ratio 1.18, 95% confidence interval 1.09‐1.26). No convincing evidence of associations for the other lifestyle factors with hand eczema were found, mostly due to heterogeneity, conflicting results, and/or the limited number of studies per outcome. [ABSTRACT FROM AUTHOR]

Background: Hand eczema (HE) is the most frequently occurring occupational skin disease. However, studies on non-occupational wet exposure, occupations not considered as high-risk, and socioeconomic factors regarding HE are scarce. Objectives: To investigate the association between HE and occupational and nonoccupational wet exposure and work-related factors in the Dutch general population. Methods: Within the Lifelines Cohort Study, participants with HE were identified by a digital, add-on questionnaire that included questions regarding exposure. Data on work-related and socioeconomic factors were collected from baseline. Results: Overall, 57 046 participants (42.0%) were included. Occupational and non-occupational wet exposure were positively associated with HE in the past year (odds ratios (ORs) 1.35, [95% confidence interval (CI): 1.22-1.49] and 1.34, [95%CI: 1.17-1.53], respectively). Positive associations for high-risk occupations (OR 1.20, [95%CI: 1.06-1.36] for personal care workers in health services and OR 1.25, [95%CI: 1.06-1.48] for nursing and midwifery professionals), occupations not considered as high-risk (OR 1.19, [95%CI: 1.03-1.39] for legal, social and religious associate professionals) and higher levels of education were found (OR 1.17, [95%CI: 1.04-1.32] and OR 1.18, [95%CI: 1.04-1.34] for middle and high level, respectively). Conclusion: Preventive strategies for HE should focus on avoidance of all wet exposure, regardless of origin. In addition, job tasks instead of job title should be taken into account. As previous results on the association between HE and socioeconomic factors differ, future research should focus on a uniform definition of socioeconomic status. [ABSTRACT FROM AUTHOR]

Background: Hand eczema (HE) has a significant impact on patients' quality of life and work‐related activities. However, little is known about the patients' perspectives on quality of care for HE. Objectives: To evaluate the patient perspective of the HE care process in a tertiary referral center. Methods: Qualitative, semi‐structured focus groups were carried out, recorded, transcribed, and analysed using an inductive‐deductive thematic approach. Results: Fifteen patients participated in four focus groups. Time and attention, together with being listened to and understood by the health care professional, were the most important aspects of care for HE mentioned by participants. Other aspects of care that were regarded as important were that diagnoses, causes and follow‐up of HE were not always clear to the participant; more psychosocial support was needed, and that participants experienced frequent changes in doctors. Information provided by nurses was valuable, but more individualized advice was needed. Conclusions: To better meet the needs of patients, more explanation should be given about the causes of HE and the final diagnosis. Besides focusing on the treatment, it is also important to focus on its impact on the patient and options for psychosocial and peer support should be discussed. Furthermore, the beneficial role of the specialized nurse as part of integrated care was emphasized. [ABSTRACT FROM AUTHOR]

Background: Several risk factors, among other lifestyle factors, have been suggested for hand eczema (HE). Objectives: To investigate a possible association between HE and lifestyle factors, including smoking, alcohol consumption, stress, body mass index (BMI), waist circumference, physical activity, diet, and amount of sleep in the Dutch general population. Methods: Data from the large population‐based LifeLines Cohort Study was used. Individuals with HE in the past year were identified by a cross‐sectional questionnaire in 2020. At baseline, information on lifestyle factors was collected. Results: In total 57 046 individuals were included in the present analysis. Smoking ≥8 cigarettes/day, and smoking ≥15 pack years showed a positive association with HE in the past year. In addition, chronic stress, a BMI >30 kg/m2, and a waist circumference of >90 cm were positively associated with HE in the past year. Conclusions: The current study indicates that lifestyle factors are associated with HE. Advice regarding lifestyle factors might contribute to enhance overall health, of which HE might possibly benefit in conjunction. Further studies should also focus on the association between lifestyle factors and the severity and prognosis of HE rather than on occurrence alone. [ABSTRACT FROM AUTHOR]

Data on chronic hand eczema and severity of hand eczema in the general population is scarce. In this crosssectional study, a questionnaire was sent to 135,950 Lifelines Cohort Study participants, in order to investigate the prevalence and severity of hand eczema in the Dutch general population. In total, 57,798 subjects were included. The lifetime prevalence of hand eczema was 15.0% (95% confidence interval 14.7-15.3), the 1-year prevalence 7.3% (95% confidence interval 7.1-7.6), and the self-reported physician-diagnosed prevalence 6.1% (95% confidence interval 5.9-6.3). The 1-year prevalence of chronic hand eczema was 4.7% (95% confidence interval 4.5-4.9). The majority (56.9%) of the subjects with hand eczema had almost clear at worst ever and the prevalence of severe to very severe hand eczema at worst ever in the general population was 1.9% (95% confidence interval 1.8-2.1). Future epidemiological studies in the general population should include data about chronic hand eczema and severity of hand eczema, as this can provide perspective on the burden of hand eczema. [ABSTRACT FROM AUTHOR]

Keywords: baricitinib; hand dermatitis; hand eczema; hyperkeratotic hand eczema; atopic hand eczema; JAK-inhibitor; treatment EN baricitinib hand dermatitis hand eczema hyperkeratotic hand eczema atopic hand eczema JAK-inhibitor treatment 419 421 3 04/14/22 20220501 NES 220501 Janus Kinase (JAK) inhibitors target the JAK and signal transducer and activator of transcription (STAT) signaling pathway that modulates T helper (Th)1, Th2, Th17, and Th22 signaling and is involved in many immune-mediated diseases. Hand dermatitis, hand eczema, treatment, baricitinib, hyperkeratotic hand eczema, atopic hand eczema, JAK-inhibitor. [Extracted from the article]

Keywords: dupilumab; hand dermatitis; hand eczema; hyperkeratotic hand eczema; treatment EN dupilumab hand dermatitis hand eczema hyperkeratotic hand eczema treatment 124 127 4 01/28/21 20210201 NES 210201 Dupilumab, a monoclonal antibody inhibiting interleukin (IL)-4 and IL-13 signaling, is currently approved for the treatment of atopic dermatitis (AD). Effective treatment of hand eczema with dupilumab has been reported previously in case series, two small retrospective cohorts, and one prospective observational study including atopic, irritant and vesicular hand eczema subgroups.1-4 However, the effect of dupilumab on isolated hyperkeratotic hand eczema (HHE) has not yet been described. Hand eczema guidelines based on the Danish guidelines for the diagnosis and treatment of hand eczema. [Extracted from the article]