1. Clinical severity and prognosis of hand eczema.
- Author
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Hald, M., Agner, T., Blands, J., Veien, N. K., Laurberg, G., Avnstorp, C., Menn, T., Kaaber, K., Kristensen, B., Kristensen, O., Andersen, K. E., Paulsen, E., Thormann, J., Sommerlund, M., Nielsen, N. H., and Johansen, J. D.
- Subjects
ECZEMA ,SKIN inflammation ,PROGNOSIS ,LOGISTIC regression analysis ,CLINICAL trials - Abstract
Background Hand eczema (HE) is a frequent, long-lasting disease with both personal and societal repercussions. Consequently, more information is needed on factors that maintain symptoms. Objectives In this study, patients with HE were followed for 6 months from the first visit to a dermatologist to identify factors associated with severe disease and a poor prognosis. Methods Study participants were 799 patients with HE from nine dermatological clinics in Denmark. Severity assessment of the HE was done at baseline and at the 6-month follow-up using the Hand Eczema Severity Index (HECSI) and by patients using a self-administered photographic guide. Additional information was obtained from a baseline questionnaire. Results At baseline, 60·3% assessed their HE as moderate to very severe using the self-administered photographic guide compared with 36·1% at follow-up. The mean HECSI value decreased from 19·9 points at baseline to 11·2 points at follow-up ( P < 0·001). In a multivariable logistic regression analysis, statistically significant associations with severe HE at baseline were older age ( P < 0·001), atopic dermatitis ( P = 0·01) and ≥ 1 positive patch test ( P < 0·001). Being an unskilled worker was a predictor for a poor prognosis at follow-up ( P = 0·04), and the presence of frequent symptoms during the previous 12 months was associated with severe initial disease ( P = 0·02) and a poor prognosis ( P = 0·04). Conclusions Overall, the disease had improved 6 months after the dermatological examination: nevertheless, many patients continued to have significant symptoms. Dermatologists should pay special attention to patients with frequent eruptions and to unskilled workers. [ABSTRACT FROM AUTHOR]
- Published
- 2009
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