Hand eczema – prognosis and consequences: a 7‐year follow‐up study

Summary 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.