Hand Eczema: Quality of Life and Disease Severity in an Outpatient Portuguese Population
Introduction: Hand eczema is a very common disease with a significant social and occupational impact.
Objectives: To characterize a Portuguese outpatient population with hand eczema; to evaluate the impairment of the disease in quality of life (QoL); to relate the disease severity with QoL.
Methods: The authors designed a prospective study. Information about atopy, psoriasis, occupational exposure and duration of disease, was recorded. The QoL was assessed by the DLQI questionnaire (Dermatology Life Quality Index) and the severity was assessed using the hand eczema severity index (HECSI). All participants were patch tested.
Results: Eighty-five patients were included with a female predominance (78.8%). The median DLQI was 9.0. We found statistically significant differences in the variable HECSI between genders with greater impact in males. A significant positive correlation was found between HECSI and DLQI. DLQI and HECSI were independent of atopy, psoriasis or etiology. Increasing age significantly affects DLQI but not HECSI.
Conclusions: Hand eczema has a significant impact in QoL. Although the disease is more prevalent among women it was found to be of greater severity among men. The QoL seems to be influenced by disease severity and increasing age but it was independent of the other studied variables.
Thyssen JP, Johansen JD, Linneberg A, Menné T. The epidemiology of hand eczema in the general population-prevalence and main findings. Contact Dermatitis. 2010;62:75-87.
Bryld LE, Hindsberger C, Kyvik KO, Agner T, Menné T. Risk factors influencing the development of hand eczema in a population-based twin sample. Brit J Dermatol. 2003;149:1214-20.
Cvetkovski RS, Zachariae R, Jensen H, Olsen J, Johansen JD, Agner T. Quality of life and depression in a population of occupational hand eczema patients. Contact Dermatitis.
Johansen JD, Aalto-Korte K, Agner T, Andersen KE, Bircher A, Bruze M, et al. European Society of Contact Dermatitis guideline for diagnostic patch testing - recommendations
on best practice. Contact Dermatitis. 2015;73:195-221.
Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI)--a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19:210-6.
Hongbo Y, Thomas CL, Harrison MA, Salek MS, Finlay AY. Translating the science of quality of life into practice: What do dermatology life quality index scores mean? J Invest
Held E, Skoet R, Johansen JD, Agner T. The hand eczema severity index (HECSI): a scoring system for clinical assessment of hand eczema. A study of inter- and intraobserver
reliability. Br J Dermatol. 2005;152:302-7.
Agner T, Andersen KE, Brandao FM, Bruynzeel DP, Bruze M, Frosch P, et al. Hand eczema severity and quality of life: a cross-sectional, multicentre study of hand eczema patients. Contact Dermatitis. 2008;59:43-7.
Hald M, Agner T, Blands J, Johansen JD. Quality of life in a population of patients with hand eczema: a six-month follow-up study. Acta Derm Venereol. 2011;91:484-6.
Bingefors K, Lindberg M, Isacson D. Quality of life, use of topical medications and socio-economic data in hand eczema: a Swedish nationwide survey. Acta Derm Venereol. 2011;91:452-8.
Moberg C, Alderling M, Meding B. Hand eczema and quality of life: a population-based study. Br J Dermatol. 2009;161:397-403.
Agner T, Andersen KE, Brandao FM, Bruynzeel DP, Bruze M, Frosch P, et al. Contact sensitisation in hand eczema patients-relation to subdiagnosis, severity and quality of life:
a multi-centre study. Contact Dermatitis. 2009;61:291-6.
Agner T, Aalto-Korte K, Andersen KE, Foti C, Gimenez-Arnau A, Goncalo M, et al. Classification of hand eczema. J Eur Acad Dermatol Venereol. 2015;29:2417-22.
Diepgen TL, Andersen KE, Brandao FM, Bruze M, Bruynzeel DP, Frosch P, et al. Hand eczema classification: a cross-sectional, multicentre study of the aetiology and morphology
of hand eczema. Br J Dermatol. 2009;160:353-8.
Nielsen NH, Linneberg A, Menné T, Madsen F, Frolund L, Dirksen A, et al. The association between contact allergy and hand eczema in 2 cross-sectional surveys 8 years
apart. Contact Dermatitis. 2002;47:71-7.
Mollerup A, Veien NK, Johansen JD. An analysis of gender differences in patients with hand eczema - everyday exposures, severity, and consequences. Contact Dermatitis.
Charan UP, Peter CV, Pulimood SA. Impact of hand eczema severity on quality of life. Ind Dermatol J. 2013;4:102-5.
All articles in this journal are Open Access under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).