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Contact sensitisation in hand eczema patients–relation to subdiagnosis, severity and quality of life: a multi‐centre study
Author(s) -
Agner Tove,
Andersen Klaus Ejner,
Brandao Francisco M.,
Bruynzeel Derk P.,
Bruze Magnus,
Frosch Peter,
Gonçalo Margarida,
Goossens An,
Le coz Christophe J.,
Rustemeyer Thomas,
White Ian R.,
Diepgen Thomas
Publication year - 2009
Publication title -
contact dermatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.524
H-Index - 96
eISSN - 1600-0536
pISSN - 0105-1873
DOI - 10.1111/j.1600-0536.2009.01630.x
Subject(s) - medicine , hand eczema , atopic dermatitis , quality of life (healthcare) , dermatology , contact dermatitis , dermatology life quality index , allergy , severity of illness , disease , immunology , nursing
Background: Contact sensitisation has been identified as a factor associated with poor prognosis for patients with hand eczema. Objectives: To study implications of contact sensitisation with respect to severity, quality of life (QoL) and subdiagnosis of hand eczema. Methods: The study was performed as a multi‐centre, cross‐sectional study from 10 European clinics. All patients were patch tested, and severity of hand eczema assessed by Hand Eczema Severity Index. A multi‐variate analysis was performed to explore which factors influenced severity, QoL and sick leave. Results: A total 416 patients were included, and 63% had contact sensitisation to one or more of the tested allergens. More women (66%) than men (51%) were sensitized. No significant association was found between sensitisation to specific allergens, disease severity, QoL or diagnostic subgroups. High age, male sex, atopic eczema and presence of contact sensitisation were independent risk factors for increased severity as measured by Hand Eczema Severity Index. Furthermore, the severity of hand eczema increased by the number of contact sensitisations detected ( P = 0.023). High age and personal history of atopic eczema were independent risk factors for low QoL, as measured by Dermatology Life Quality Index, and atopic eczema as well as allergic contact dermatitis as subdiagnosis was associated with increased sick leave. Conclusion: Diagnostic subgroups were not found to be related to specific allergens. Contact sensitisation was found to be a risk factor for increased severity of hand eczema, as did high age, male sex and atopic eczema.