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Eczema is a complex disease to self-manage, between tackling the flares, following a regular maintenance regimen and avoiding triggers. It also has an impact on all aspects of life of infants, children, young people and their families, from self-esteem to relationships, education and social activities, mainly due to persistent itching and pain, sleep disturbance and emotional distress. Effective treatment of eczema demands good self-management which, if established early on, can lead to considerable improvements in quality of life and adherence to an agreed plan. [ABSTRACT FROM AUTHOR]

Work-related skin conditions, including work-related irritant and allergic contact dermatitis, rank as the second most prevalent among work-related diseases. The most commonly reported manifestation of these conditions is hand eczema, which develops due to exposure to various substances in the workplace. Understanding the origins and triggers of eczema and contact dermatitis enables healthcare professionals to educate themselves and their patients about effective preventive measures, such as avoiding specific irritants and allergens, using protective equipment, and maintaining proper skincare hygiene. Additionally, this knowledge facilitates the development of new recommendations to enhance skin protection in work-related settings, regulate the use of substances known to cause work-related skin diseases, and provide healthcare practitioners with the necessary training to recognize and manage these conditions. Given that approximately one in every five healthcare workers is considered to have hand eczema, the objective of this study was to review the existing literature regarding the characteristics of eczema in healthcare workers. Furthermore, this study aimed to comprehensively investigate environmental and constitutional factors (including years of work experience involving exposure to skin hazards, frequent glove use, regular handwashing and water contact, frequent use of disinfectants and detergents, and a history of previous allergies and atopic dermatitis) that influence the occurrence and progression of eczema. [ABSTRACT FROM AUTHOR]

Moxibustion therapy is a treatment and health-care method that originated from China. It is a kind of therapy for preventing and treating diseases by stimulating meridians and acupoints using heat to regulate the viscera and enhance immunity. This article introduces the definition and mechanism of moxibustion technology, clinical operation technics, and precautions of moxibustion in practice, and demonstrates plenty of iconic cases of application of moxibustion in the treatment of insomnia, dysmenorrhea, urinary retention, knee arthritis, chronic eczema, etc., so as to provide a reference for the wide application of moxibustion technology. [ABSTRACT FROM AUTHOR]

Background: Parents of children with eczema are increasingly turning to online parenting forums for advice about how to manage it. Little is known about how parents make sense of advice about eczema treatments in online forums, and how it affects their management of childhood eczema. Aim: To explore how parents of children with eczema make sense of and act on advice about eczema treatments exchanged in online parenting forums. Design & setting: Qualitative interviews with parents of children with eczema from the UK. Method: Fifteen parents were recruited through online advertisements and snowball sampling. Semi-structured interviews were carried out face to face or by telephone, and analysed inductively using reflexive thematic analysis. Results: When seeking advice from online parenting forums about eczema treatments, parents described appraising the credibility of advice and considering the potential suitability of treatments that were recommended in the forum. Parents proceeded to make sense of online advice through either reading advice and not engaging in online discussions, or actively engaging in online discussions to direct topics and seek most relevant advice. Parents discussed advice received online in subsequent consultations with their GP and requested prescriptions of recommended treatments. Some parents described trying new treatments without consulting their GP. Conclusion: Understanding how parents appraise, make sense of, and act on online advice could support healthcare professionals to disseminate advice appropriately, ask additional questions, and signpost parents to reliable online resources. [ABSTRACT FROM AUTHOR]

Eczema (atopic dermatitis) is a chronic skin condition that adversely affects the quality of life due to physical changes and subsequent mental health consequences of eczema. There is a need to highlight the psychological comorbidities of eczema and their impact on quality of life. Most of the emerging detail requires testing findings of recent studies in addition to further exploration that can be taken together, it might be sensible to monitor the general health of individuals with eczema. This mini review briefly discusses the psychological comorbidities such as sleep disturbance, psychological distress and suicidal ideation in eczema patients. Further researches need efforts to address the short and long term mental health consequences and how novel treatment options may potentially be helpful in improving of the quality of life of eczema patients. [ABSTRACT FROM AUTHOR]

Background: COVID-19 hand hygiene recommendation had resulted in a hand eczema -exacerbation. The guidelines of care for the management of hand eczema recommend the use of educational interventions for patients. Objective: An educational intervention was designed to increase the patient's knowledge of appropriate hand hygiene and improve the patient's symptoms. Methods: The validated self-assessment patient-oriented eczema measure tool and pre- and post-tests were used to measure outcomes prior to educational intervention and again in 1–2 months postintervention. Of the 26 participants enrolled, 21 completed the study. The study included newly diagnosed or established patients with eczema, and the education material was available for all patients. Results: The difference between the average pretest and initial posttest was statistically significant (df = 20, P (T ≤ t) = 0.000663535, p <.05). Similarly, the difference between the average pretest and follow-up posttest was also statistically significant (df = 20, P (T ≤ t) < 0.001, p <.05). Participants also had a 2.04 mean point decrease in symptoms severity. Conclusions: The results demonstrated an improvement in patient's knowledge and reduction in symptoms. Implications for Nursing: The program can serve as a new guideline for managing hand eczema symptoms due to COVID-19 in the adult population in the private office setting. [ABSTRACT FROM AUTHOR]

Eczema is very common in children. Although in the majority of children the disease is mild, even in mild cases eczema can lead to poor quality of life. The relationship with food allergy, the choice and safety of topical treatments can be confusing. This article aims to simplify the approach and treatment of paediatric eczema and offers practical advice to healthcare professionals caring for children with eczema. [ABSTRACT FROM AUTHOR]

Community nurses often encounter people with red legs. There are a number of reasons why an individual may develop red legs. The most common causes of red legs are cellulitis, venous eczema and lipodermatosclerosis. All have different causes and require different treatments. This article aims to enable readers to differentiate between these conditions which can appear similar, and to offer effective evidence-based care. [ABSTRACT FROM AUTHOR]

Venous eczema—also known as varicose, gravitational or stasis eczema—is a common form of eczema. In fact, 37−44% of patients with leg ulcers can present with a venous eczema. It is highly unpleasant, and can disrupt an individual's personal and social life. In this article, Drew Payne provides a community nurse's perspective on what venous eczema is, how to manage it in patients, and how to prevent further reoccurences. [ABSTRACT FROM AUTHOR]

The article presents a case study of a male patient with venous leg ulceration and compression hosiery that had not been changed for 2.5 years.

The article presents a case study of a 44-year-old woman with childhood trauma. Topics include seeking treatment from a medical dermatologist prescribing a cortisol cream; eosinophilic esophagitis being a chronic immune system disease such as a type of white blood cell connecting mouth to the stomach; and treating skin conditions such as eczema, dermatitis, psoriasis, and poison ivy.

Allergic rhinitis and eczema are two common global diseases that can lead to impaired quality of life. Determining the prevalence of these allergic disorders can be useful in planning prevention and treatment. This study aimed to investigate the prevalence and severity of allergic rhinitis and eczema in adolescents living in Yazd city. Using an electronic questionnaire based on the Global Asthma Network (GAN) core questionnaire, 5141 adolescents aged 13-14 years were cross-sectionally surveyed. The prevalence of current symptoms of rhinitis turned out to be 36.3%, proving significantly higher in boys (p=0.009). Moreover, the prevalence of allergic rhinitis and rhinoconjunctivitis in the past year leveled at 12.4% and 10.5%, respectively; however, the former was significantly higher in females (p=0.014). Additionally, severe rhinoconjunctivitis was observed in 0.2% of the participants with no gender preference (p=0.09). Confirmed hay fever by a doctor was reported in 13.2% of adolescents, significantly higher in males (p<0.001). The prevalence of current itchy rash and current eczema was found to be 5.5%, and 2.9%, respectively, with no difference in terms of gender. Severe atopic eczema and eczema confirmed by a doctor were seen in 0.4% and 5% of the participants, no gender preference was identified. Concurrent prevalence of current rhinoconjunctivitis and eczema was detected in 1% of the participants. Despite the increasing trend of allergic diseases in most parts of the world, the prevalence of rhinoconjunctivitis and eczema in adolescents has not increased in Yazd in the last two decades, and this city is located in a low to moderate prevalence area. [ABSTRACT FROM AUTHOR]

The article presents a case study of a male patient with leg ulcers, gross oedema and varicose eczema.

Background: Recap of atopic eczema (RECAP) is a patient-reported outcome measure (PROM) assessing eczema control. Long-term control of eczema is one of the four core outcome domains for atopic eczema trials. This instrument has been recently developed in the UK. Objective: This study aimed to translate the English RECAP into German and test its content validity in a German population with self-reported atopic eczema. Methods: A six-step procedure including two forward and one backward translations, two consensus decisions and an expert review was performed to obtain a German version of RECAP. We conducted semi-standardized cognitive interviews with adults with atopic eczema (n = 7) and parents having children affected by this disease (n = 5). A "think-aloud" method was used and aspects of comprehensibility, comprehensiveness and relevance according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria were examined. Interviews were coded using qualitative content analysis. Results: No particular linguistic problems were encountered during forward-backward translation. Minor wording changes were made as required. The title was adjusted to a more familiar German term of the disease (which is 'Neurodermitis'). The recall period was rephrased from 'over the last week' to 'over the last seven days' since there was a different cultural understanding of the time frame. Regarding content validity, the items of the German RECAP were considered to be comprehensible, comprehensive and relevant for the participants and parents of affected children. The participants understood the instruction and considered the one-week recall period and the response options as appropriate. Conclusions: A German version of RECAP that is linguistically equivalent to the original version is now available but further assessment of its measurement properties is needed. [ABSTRACT FROM AUTHOR]

This short article considers the seasonal impact of weather and climate on skin, and in particular eczema, as well as the role therapeutic moisturisers and cleansers can play in keeping skin healthy as the temperature drops. [ABSTRACT FROM AUTHOR]

Age-related changes lead to an increase in skin problems, and around 70% of older people have a treatable skin condition. However, ageing and poor physical health can make it difficult for older people to care for their skin. Eczema, a chronic inflammatory skin condition, where the skin becomes red, inflamed, itchy and scaly, can develop easily in older adults. This can, in turn, become infected and cause discomfort and health problems. This article explains how ageing affects the skin, how eczema can develop and how it can be treated, also touching upon the different types of eczema. It aims to equip community nurses with knowledge about this common condition and how to recognise and manage it. [ABSTRACT FROM AUTHOR]

Objective: To explore the clinical medication law of Professor Liu Taofeng in the treatment of eczema by using data mining technology. Methods: the cases of eczema treated by Professor Liu Taofeng in the outpatient department of the First Affiliated Hospital of Anhui University of traditional Chinese medicine from June 2018 to October 2019 were collected and sorted out. The database was established with the help of Microsoft Excel 2016, SPSS statistical 24.0 and SPSS modeler 18.0 computer software, and the frequency analysis, high-frequency drug association rule analysis and cluster analysis were carried out. Results: among the 255 prescriptions included in the study, 41 traditional Chinese medicines were involved, and the top 10 drugs were fresh white skin, cortex Scutellariae, Cortex Moutan, Tribulus terrestris, Sophora flavescens, Salvia miltiorrhiza, Atractylodes macrocephala, Poria cocos, liquorice, and Cynanchum paniculatum; 10 pairs of 2 drugs were associated by association analysis, such as "Tribulus terrestris → fresh white skin, Sophora flavescens → cortex Scutellariae"; and "Poria cocos, Atractylodes macrocephala, lentils" were obtained by cluster analysis. Conclusion: Professor Liu Taofeng paid more attention to the heart and liver in the treatment of eczema, taking clearing away heat, cooling blood and removing dampness as the main treatment, and paid more attention to invigorating the spleen and stomach or removing blood stasis. [ABSTRACT FROM AUTHOR]

High standards of patient care and education in primary care dermatology is a constant need, as the pressure on dermatology referrals to secondary care continually increases. The BDNG Primary Care Subgroup discuss key issues in primary care dermatology and offer guidance and solutions to improve patient care. The issues covered include emollients and eczema management, acne management with a focus on antibiotic prescribing and stewardship, recognising skin lesions and skin cance [ABSTRACT FROM AUTHOR]

Eczema in children is usually of mild or moderate severity, but it can have a significant psychosocial impact and be challenging to treat. This article discusses the diagnosis and treatment of mild to moderate eczema in children, which can usually be effectively managed in primary care. [ABSTRACT FROM AUTHOR]

Nummular microbial eczema is characterized by a severe, often relapsing course with resistance to standard therapies, which leads to an increase in cases of temporary disability and the need for hospitalization of patients. The aim of the study was to evaluate the clinical and immunological effectiveness of the immunomodulator Imunofan in the treatment of moderate nummular microbial eczema to substantiate its practical application. 80 patients, among them 50 women (62.5%) and 30 men (37.5%) aged from 35 to 56 years old were included in the main group, where complex therapy was applied. The control group, where standard therapy was applied, included 104 patients, among them 62 women (59.6%) and 42 men (40.4%) aged 35 to 56 years. The group of healthy donors included 50 people: 32 women (64%) and 18 men (46%) aged 35 to 55 years. Evaluation of the clinical efficacy of the treatment was carried out using the index of severity of microbial eczema and the dermatological quality of life index, the quantitative determination of TNF-α in serum was performed by enzyme immunoassay. The results of the study showed that the use of the immunomodulator Imunofan in the complex therapy of patients with moderately severe nummular microbial eczema reduced the activity of the inflammatory process in the skin by reducing the amount of TNF-α in the blood serum, obtaining a positive dynamic of the clinical picture, reducing the risk of recurrence and reduce the time of hospitalization. [ABSTRACT FROM AUTHOR]

The considerable heterogeneity of outcomes and measurement instruments in hand eczema trials substantially limits the evidence synthesis concerning therapeutic and preventive interventions. Therefore, the Hand Eczema Core Outcome Set (HECOS) initiative is developing a core outcome set for future trials. The first objective was to identify outcomes that were measured in previous trials, to group them in domains, and to identify their measurement instruments. We conducted a systematic review of controlled and randomized controlled hand eczema trials published since 2000. Sixty‐one eligible studies were identified. Each assessed one or more of 47 outcomes in the "skin" domain. Eighteen trials (30%) additionally focused on preventive behaviour in risk occupations. Quality of life was measured in 13 studies (21%). Thirty‐two distinct named instruments were applied, but 223 measurements (62%) were conducted with unnamed instruments. Only 32 studies (52%) defined a primary outcome. Twenty‐nine trials (48%) provided some information on adverse events, but none gave any references concerning relevant methods. Our review confirms the need to harmonize outcome measurements in hand eczema trials. The findings form the basis for a consensus process to generate a core outcome set to improve the explanatory power and comparability of future hand eczema studies. [ABSTRACT FROM AUTHOR]

The multitude of treatment options for atopic dermatitis (AD) makes management frustrating for providers and patients. Eczema action plans (EAPs) have been proposed to improve parental and provider management. We developed a single-site randomized controlled trial to evaluate the impact of an EAP on quality of life (QOL), provider knowledge, and comfort with AD management. Providers were randomized into an EAP-use group and a traditional care group. All patients completed validated AD QOL surveys, and those with AD were verbally administered the survey 1 month later. Providers’ perceptions on managing AD were compared in the EAP and usual use groups. Parents in the EAP group demonstrated a significantly increased understanding of AD treatment, and providers in the EAP group had a significantly increased understanding and management of AD. The EAP is a feasible tool that can be integrated into a busy clinic practice with a positive impact on physicians and patients. [ABSTRACT FROM AUTHOR]

We investigated factors associated with quality of life (QOL) in children with eczema. We conducted a cross-sectional analysis of survey data from 224 parents of children with eczema attending a large, hospital-based pediatric clinic. Parents completed a validated eczema severity scale (Patient-Oriented Eczema Measure), a QOL scale (Infants’ Dermatitis QOL Index or Children’s Dermatology Life Quality Index), and a knowledge and understanding questionnaire. In adjusted multivariate analyses, worse eczema severity was associated with worse overall QOL (β = 0.5; 95% confidence interval [CI] = [0.5, 0.6]), while a higher knowledge score was associated with better QOL (β = −3.4; 95% CI = [−6.6, −0.2]). Similarly, even after adjustment for eczema severity, greater understanding of a child’s individual treatment plan was associated with better QOL (β = −0.7; 95% CI = [−1.4, −0.08]), while increased frequency of worrying about a child’s eczema was associated with worse QOL (β = 0.7; 95% CI = [0.03, 1.1]). These results suggest primary care providers may be able to influence QOL through optimal eczema management and family education. [ABSTRACT FROM AUTHOR]

Aim: To investigate whether the skin barrier function is impaired with regard to the pH value, water content, transepidermal water loss (TEWL), and the integrity of the stratum corneum, and whether the expression of caspase-14 is altered in moderate to severe chronic hand eczema (CHE).Methods: Thirty patients with moderate to severe CHE treated at our institute and 30 healthy volunteers were included in this study. The pH value, water content, TEWL, and the integrity of the stratum corneum were measured in all subjects.Results: Significantly increased pH value, decreased water content, elevated TEWL, and impaired integrity of the stratum corneum were observed in the lesional skin of CHE patients compared with the nonlesional skin of CHE patients and the normal skin of healthy volunteers. The expression of caspase-14 decreased in the lesional and nonlesional skin of CHE patients compared with the normal skin of healthy volunteers, especially prominent in the nonlesional skin. The mean optical density (OD) value of immunohistochemical staining for caspase-14 was significantly lower in the nonlesional skin than in the lesional skin and normal skin (p < 0.01 for both). Although the mean OD value was lower in the lesional skin than in the normal skin, the difference was not statistically significant (p > 0.05).Conclusion: Skin barrier dysfunction indeed occurs in CHE patients, which may be related to mechanisms associated with a downregulated expression of caspase-14. [ABSTRACT FROM AUTHOR]

Background: Several studies were conducted to investigate the association between eczema and risk of depression. This was important because the care of patients with eczema might be inadequate if their psychological problems were not also recognized and treated. However, these studies had some inherent limitations such as small sample sizes or lack of controlling for potential confounders. Further, little was known about psychological co-morbidity of eczema from a global perspective.Methods: We conducted a systematic literature search in PubMed (1966 through January 26th 2017), Cochrane Library (the Cochrane central register of controlled trials, up to January 26th 2017), Scopus (up to December 31st 2016) and Embase (1980 through January 26th 2017) supplemented by manual searches of bibliographies and conference proceedings. The relative risk (RR) with 95% confidence interval (CI) was estimated.Results: Ten studies with a total of 188,495 patients were included. Overall, the random effects model summarizing all comparisons suggested a positive association between eczema and risk of depression, the pooled RR was 2.02 (95% confidence interval 1.76 to 2.31, I² = 33.7%). Similar results were observed in subgroup analysis by region.Limitations: Methodological limitations such as selection biases, sample sizes, severity of other diseases, treatment strategy, age and other factors might have influenced the results.Conclusions: Our study showed that patients with eczema were associated with an increased risk of depression. These findings implicated that clinical doctors should continue to be more aware of the association between eczema and the risk of depression. [ABSTRACT FROM AUTHOR]

Eczema can be unsightly, itchy, and painful, and can put children at risk for infection when it flares. It can also disturb their sleep and cause embarrassment, while being time-consuming and costly for parents to manage. There is no cure for eczema, but there are many treatment options available to help alleviate the symptoms. Despite the availability of treatments, access to quality products, cost of medications, and a lack of understanding of the treatment plan often leave parents feeling overwhelmed, with children continuing to suffer from chronic itch and pain. Using various educational strategies, nurses can help families navigate the treatment principles and give children the best chance of soothing and repairing their skin while preventing future flares. [ABSTRACT FROM AUTHOR]

Introduction: Our objectives were to assess patient-reported improvement after patch testing at the 2-3-month follow-up visit in patients referred for patch testing with relevant positive patch test reactions at the University of California, San Francisco.Methods: Cross-sectional analyses of patients patch tested between 2013 and 2016 who returned for a follow-up visit approximately 2-3 months after patch testing. We examined positive patch test results considered of definite, probable or possible relevance to the patient’s eczematous eruptions. Patients reported improvement after patch testing as a percentage: 0-100%. Patients were categorized into four groups: (1) those that reported no improvement or worsened, (2) those that reported > 0% and ≤ 60% improvement, (3) those that reported > 60% but < 100% improvement and (4) those that reported 100% improvement. Secondary measures included the association of allergens, gender, age and location of the rash.Results: The majority (81%) of patients seen at follow-up reported improvement after patch testing. Women reported more improvement than men with statistical significance. Notably, there does not appear to be a statistically significant relationship in patient-reported improvement and age, atopy, strength of a the patient’s positive reactions, number of positive reactions and follow-up time or with potential systemic contact allergens (i.e., balsam of Peru, nickel, chrome and cobalt).Conclusion: We find the large percentage of patients that self-report global benefit from patch testing encouraging, as we believe this to be a powerful measure of disease and symptom activity, as well as quality of life. The gender differences we found contradict the previous literature. [ABSTRACT FROM AUTHOR]

Food allergies can be distressing for parents and children, and a challenge for healthcare professionals. This article looks at differentiating IgE and non-IgE mediated reactions, the link to eczema, referral, management and treatment. [ABSTRACT FROM AUTHOR]

Abstract: Background/Objectives: Knowledge of and phobias about topical corticosteroids in parents of infants with eczema affect efficacy of eczema treatment. Methods: We surveyed 300 parents of children with eczema using a questionnaire to investigate knowledge of and phobias about topical corticosteroids. Results: Overall, 85.7% (n = 257) of children had used topical corticosteroids, with 12.8% (n = 33) of children having steroids applied for only 1‐3 days per episode; 79.4% (n = 204) of patients discontinued topical steroid therapy immediately after improvement. Twenty‐five percent (n = 75) of parents refused a prescription of steroid ointment, and 32.3% (n = 97) did not use the steroid ointment on their children despite having received a prescription. During steroid treatment, 95.7% (246) of parents were very concerned about the side effects of topical steroids. One hundred eight parents (42%) did not use a topical steroid ointment for recurrence of eczema because of concerns about using topical corticosteroids. Conclusion: Most parents of infants with eczema had excessive concerns about topical corticosteroids, leading to inadequate treatment of atopic dermatitis. In clinical practice, physicians should reinforce parents' understanding of steroid treatment for eczema and guide rational use of topical steroids for infantile eczema. [ABSTRACT FROM AUTHOR]

Occupational hand eczema is a type of eczema specifically affecting the hands and caused by a person's work. It often affects people whose hands get wet a lot or are exposed to chemicals when working, such as hairdressers and cleaners. It can cause a great deal of distress to people, affecting their health-related quality of life (HRQoL) and often meaning they have to leave work or change jobs. It is a major reason for people seeking disability benefit in countries including the UK, so as well as having a negative impact on the patient, it also impacts on society more widely. In theory, occupational hand eczema should heal when the exposure is removed; however, several studies have shown that this is unfortunately not the case in reality, and some patients may continue to have severe hand eczema symptoms. This study involved 1496 people who were suffering from occupational hand eczema in Denmark in 2010 and 2011, who then completed a questionnaire 5 years later, asking questions about their job, their eczema and their quality of life. 48.7% were still in the same profession, 32.6% had changed profession and 18.8% were not working (outside the labour market, e.g. retired, unemployed, on parental leave). Healing of hand eczema (meaning their hands were now clear of eczema) was reported by 19.5% of the participants who changed their profession and 27.3% of the participants who outside the labour market, compared with 15.8% of those still in the same profession. Looking at improvement (but not healing) of their eczema, 64.9% of the participants who had changed profession and 58.2% of the participants outside the labour market reported improvement in their hand eczema compared with 53.1% of the participants still in the same profession. However, health related quality of life was not improved by changing jobs or leaving work, and in fact worsened. Also, the authors did not ask if the participants changed to a profession with more or less exposure than the previous profession, so it is possible that some participants have changed to another high risk profession, thereby diminishing the effect of change. These two points both need further research. [ABSTRACT FROM AUTHOR]

Hand eczema is one of the most common skin diseases with some studies estimating that up to 10% of the European population has some degree of hand eczema at any one time. There are various causes with some people having a genetic tendency and others developing hand eczema due to their jobs, often a result of hand washing in healthcare or hospitality sectors. The initial treatment of hand eczema is to avoid obvious triggers and use plenty of moisturising creams. If problems continue steroid creams are prescribed. These measures are often enough but if the eczema continues patients are then offered either ultraviolet (UV) light based treatments or tablets. This research study investigated two different forms of UV light treatment which are used to treat eczema. PUVA involves soaking the hands in a water-based solution of a photosensitising drug before receiving UVA light for 5-15 minutes whereas NBUVB involves a 1-2 minute exposure to UVB light. PUVA is the traditional treatment and has been used for 30 years. It is time consuming. There are some concerns that excessive PUVA use could increase the risk of skin cancers and indefi- nite repeated treatment is not used. The research study invited patients with hand eczema not improving with steroid creams to receive either PUVA or UVB treatment. The severity of their eczema was scored before, during and after treatment. Due to difficulties in recruiting enough patients it was not possible to say which treatment was better. However, the study did show that both treatments improved the eczema severity. There were more side effects with the NBUVB treatment mainly due to mild episodes of skin redness. This research has provided new information. We now know that NBUVB is a safe and acceptable treatment for hand eczema. It does lead to improvement in hand eczema severity. It takes less time but does produce more side effects than PUVA. We have measured the improvement in patients' eczema with both treatments using official scoring systems which means we are now in a position to design a larger clinical trial to determine which treatment is more effective. [ABSTRACT FROM AUTHOR]

Background: The regular use of cosmetic products plays a role in the management of hand eczema (HE) and aids in improving barrier function reducing dryness, roughness, pruritus and improving quality of life (QoL). The aim of this open-label study was to assess the efficacy and the reparative effect of a dermo-cosmetic product on subjects suffering from HE after 7 and 21 days of daily application. Methods: The product was a water-in-oil (W/O) emulsion containing the active ingredients Avène thermal spring water, sucralfate, and copper and zinc sulfates. In total, 32 subjects suffering from either contact dermatitis or climatic dermatitis participated in the trial. The modified total lesion symptom score and physician global assessment scores were used to describe the severity of HE. The safety of the product was assessed through clinical scoring. The subjective tolerance, and acceptance, were documented using a self-assessment questionnaire completed by the subjects. The impact of the dermatosis on QoL was evaluated using the Dermatology Life Quality Index. Results: After 7 days of application, both the physician and subjects noticed a significant improvement in HE. The formula was very well tolerated and accepted. These benefits were correlated with a significant improvement in QoL. Conclusion: The W/O emulsion used in this study demonstrated real benefits for the subjects suffering from contact dermatitis and climatic dermatitis. [ABSTRACT FROM AUTHOR]

The article discusses issues related to the care and management of older people suffering from eczema. It cites intrinsic and extrinsic changes that contribute to functional changes in the skin that are related to ageing. It offers information on the various types of eczema, including asteatotic and venous eczema. It also recommends ways to manage contact dermatitis and drug-related eruptions caused by taking numerous medications.

Background: Azathioprine is frequently used in severe eczema. It is converted in the liver into active metabolites, including 6-thioguanine nucleotide (6-TGN) and methylated 6-methylmercaptopurine (6-MMP). In the past, the therapeutic potential of azathioprine may have not been fully utilized. Recent investigations on inflammatory bowel disease have led to a better understanding of azathioprine metabolism and optimizing treatment. Objective: To investigate whether measuring thiopurine metabolites in circulation can improve the effectiveness and safety of azathioprine treatment in patients with atopic dermatitis and/or chronic hand/foot eczema. Methods: Azathioprine metabolite levels were measured in eczema patients during maintenance treatment (Part I) and dose escalation (Part II). Clinical effectiveness, hepatotoxicity, and bone marrow suppression were analyzed and TPMT genotype was assessed. Results: A wide variation in metabolite levels in all dose groups was observed. In Part I (32 patients), there were no significant differences in 6-TGN levels between clinical responders and non-responders (p = .806). No hepatoxicity or myelotoxicity was observed. In Part II, all 6-TGN and 6-MMP levels increased during dose escalation. Hypermethylation was observed in 2/8 patients. Conclusion: For individual eczema patients treated with azathioprine, routinely measuring 6-TGN and 6-MMP can be helpful in optimizing azathioprine dose, improving clinical effectiveness, and preventing side effects. [ABSTRACT FROM AUTHOR]

Abstract: This guideline was developed as a joint interdisciplinary European project, including physicians from all relevant disciplines as well as patients. It is a consensus‐based guideline, taking available evidence from other guidelines, systematic reviews and published studies into account. This second part of the guideline covers antimicrobial therapy, systemic treatment, allergen‐specific immunotherapy, complementary medicine, psychosomatic counselling and educational interventions, whereas the first part covers methods, patient perspective, general measures and avoidance strategies, basic emollient treatment and bathing, dietary intervention, topical anti‐inflammatory therapy, phototherapy and antipruritic therapy. Management of AE must consider the individual clinical variability of the disease. Systemic immunosuppressive treatment with cyclosporine, methotrexate, azathioprine and mycophenolic acid is established option for severe refractory cases, and widely available. Biologicals targeting the T helper 2 pathway such as dupilumab may be a safe and effective, disease‐modifying alternative when available. Oral drugs such as JAK inhibitors and histamine 4 receptor antagonists are in development. Microbial colonization and superinfection may cause disease exacerbation and can require additional antimicrobial treatment. Allergen‐specific immunotherapy with aeroallergens may be considered in selected cases. Psychosomatic counselling is recommended especially in stress‐induced exacerbations. Therapeutic patient education (‘Eczema school’) is recommended for children and adult patients. General measures, basic emollient treatment, bathing, dietary intervention, topical anti‐inflammatory therapy, phototherapy and antipruritic therapy have been addressed in the first part of the guideline. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Exact etiology and proper treatment of eczema are still unknown. The hygiene hypothesis and epidermal barrier dysfunction hypothesis attempted to give some plausible explanations for these issues but they still remain unclear. The identification of factors, including hygiene practices, related to eczema symptoms (ES) could shed some light on these matters. Therefore, this study aimed to determine risk factors related to ES and the ES prevalence in two disparate areas in terms of urbanization in Aceh, Indonesia. Methods: A cross‐sectional study with convenience sampling was conducted among schoolchildren living in urban and rural Aceh. Data on ES, socio‐demographic characteristics, environmental factors, partial ablution and other hygiene related factors were collected by parental questionnaires. In addition, children's anthropometric measurements were also collected. Results: The prevalence of current ES in the study population was 21%. When stratifying by residency, the prevalence of ES in urban and rural area was 20.93% versus 21.05%. Partial ablution was independently associated with a reduced risk of ES (OR = 0.36; 95% CI 0.13–0.96). Important risk factors for ES were paternal history of allergic disease (OR = 4.09%; 95% CI 1.51–11.11) and belonging to the older group of schoolchildren (10–13 years old) (OR = 2.57; 95% CI 1.03–6.40). Conclusions: There were no significant differences in the prevalence of ES between urban and rural settings, and partial ablution had a protective effect on ES. These findings support the epidermal barrier dysfunction hypothesis as a possible pathway of eczema. [ABSTRACT FROM AUTHOR]

Acute eczema is a difficult clinical common skin disease, patients can appear blisters, skin erosion, exudation and other symptoms, severe cases can cause skin necrosis or ulcers, and then generalized body. In recent years, the incidence and recurrence rate of acute eczema are rising, and seriously affect the physical and mental health and quality oflife of patients. As an effective treatment of acute eczema, traditional Chinese medicine has a long history and remarkable clinical curative effect. It has a good therapeutic effect in reducing the side effects of acute eczema and preventing the recurrence of the disease. Through the analysis of relevant literature in recent years, the traditional Chinese medicine literature on eczema, to sum up the cause of acute eczema pathogenesis, reviewed the experimental and clinical study of traditional Chinese medicine, in order for the clinical treatment of acute eczema and provide a theoretical basis. [ABSTRACT FROM AUTHOR]

Objective: Chronic diseases now represent a cost majority in the United States health care system. Contributing factors to rising costs include expensive novel and emerging therapies, under-treatment of disease, under-management of comorbidities, and patient dissatisfaction with care results. Critical to identifying replicable improvement methods is a reliable model to measure value.Study Design: If we understand value within healthcare consumerism to be equal to a patient's health outcome improvement over costs associated with care (Value=Outcomes/Costs), we can use this equation to measure the improvement of value.Methods: Research and literature show that patient activation-the skills and confidence that equip patients to become actively engaged in their health care-impact health outcomes, costs, and patient experience. Reaching patient activation through engagement methods including shared decision-making (SDM) lead to improved value of care received. The National Eczema Association (NEA) Shared Decision-Making Resource Center can be a transformative strategy to measure and evaluate value of health care interventions for eczema patients to advance a value-driven health care system in the United States.Results: Through this Resource Center, NEA will measure patient value through their own perceptions using validated PRO instruments and other patient-generated health data.Conclusions: Assessment of this data will reveal findings that can assist researchers in evaluating the impact this care framework on patient-perceived value across other chronic diseases. [ABSTRACT FROM AUTHOR]

Parvovirus B19 (PVB19) is a virus found in the skin that causes asymptomatic infections and can exist in the host for long periods to time. The virus induces a local inflammatory response and is associated with the development of arthritis and other autoimmunes diseases. Parvovirus B19 DNA was investigated by PCR in the skin of 20 patients with psoriasis and 20 patients with eczema. Additionally, immunohistochemistry was used to characterize the expression of cytokines in these lesions. The sociodemographic variables were similar in the two groups studied. Psoriasis vulgaris was the most common clinical type in men (50%) and women (80%) (p = 0.0106). Comorbidities were observed in most patients with psoriasis (75%), with an OR of 14 (p = 0.0068). Another important finding was the high prevalence (50%) of psychiatric disorders in patients with psoriasis (OR = 16, p = 0.0218). Only two patients (10%) with psoriasis were positive for PVB19. Comparison of cytokine expression showed the same cytokine profile in the two groups (p > 0.05). However, expression of TNF-α tended to be higher in psoriasis patients. There was no significant positivity for PVB19 in the two groups studied. Immunohistochemistry showed higher expression of TNF-α in psoriasis lesions compared to the eczema group. [ABSTRACT FROM AUTHOR]

Summary: Background: Only a few clinical trials on hand eczema have included further classification into subtypes, and there is a need for studies evaluating the present classifications. Objectives: To examine differences in demographic factors, lifestyle factors and severity between subgroups of hand eczema patients, with a focus on hyperkeratotic hand eczema. Methods: This was a retrospective study including hand eczema patients referred to the outpatient dermatological clinic, Bispebjerg Hospital, between January 2013 and July 2014. The study comprises information on subdiagnoses, treatment and foot eczema from patient files, as well as a follow‐up questionnaire. Results: A total of 120 patients were included, 10 of whom were diagnosed with hyperkeratotic hand eczema. A significantly higher proportion of the patients with hyperkeratotic hand eczema were male (p = 0.002) and received systemic or ultraviolet (UV) treatment (p = 0.026). The frequency of tobacco smoking was significantly higher in patients with hyperkeratotic hand eczema (p = 0.016), as well as in the other subgroups combined (p = 0.049), than in the background population. Conclusions: Studies evaluating the subdiagnoses of hand eczema are needed, to further validate the classification system, and to provide more detailed information about demographic factors, severity and possible risk factors for different subgroups of hand eczema. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 39-year-old woman with a known history of atopic dermatitis (AD) and referred to the dermato-allergology department due to persistent, painful, hyperkeratotic palmoplantar eczema despite the use of betamethasone dipropionate ointment and emollients. The patient was treated with intramuscular injections of methotrexate (MTX) and folic acid. The treatment of MTX was stopped after one year due to the improvement in AD lesions.